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Case Manager Survey

Schuylkill Rehabilitation Center is committed to providing high quality therapy services. We wish to obtain your assessment of our services in order to help meet these high standards. Your feedback is an essential component to our strategic planning and outcome data management. We would be more than grateful if you could complete the following questionnaire.

Check each question in a rating from 1 (Never) to 7 (Always):

  1. Were written progress notes beneficial?
    Never   Always
    1   2   3   4   5   6   7
    Comment:

  2. Were progress notes:

    Timely?
    Never   Always
    1   2   3   4   5   6   7

    Accurate?
    Never   Always
    1   2   3   4   5   6   7

    Comprehensive?
    Never   Always
    1   2   3   4   5   6   7
    Comment:

  3. When verbal communication about your patients’ progress was made, was it beneficial?
    Never   Always
    1   2   3   4   5   6   7
    Comment:

  4. Was the first appointment scheduled in a timely manner?
    Never   Always
    1   2   3   4   5   6   7
    Comment:

  5. Do you believe your patient(s) improved because of treatment at Schuylkill Rehabilitation Center?
    Never   Always
    1   2   3   4   5   6   7
    Comment:

  6. Overall, were you satisfied with the services provided by Schuylkill Rehabilitation Center?
    Never   Always
    1   2   3   4   5   6   7
    Comment:

  7. Will you continue to refer to our services if needed in the future?
    Never   Always
    1   2   3   4   5   6   7
    Comment:

  8. Are there other services or additional equipment which Schuylkill Rehabilitation Center could be providing to your patients?
    None at this time
    Yes, please explain:

  9. What outcome information is valuable for you to obtain?
    Percentage of patients who accomplish goals.
    Percentage of patients who return to work.
    Percentage of patients who maximized return to active productive life role.
    Efficiency and cost data.
    Effectiveness and duration data.
    Functional levels compared at 90-day follow-up.
    All of the above.
    Other:

  10. How should we communicate our current services and outcome information?
    Please select one choice from each column:
    Brochures
    Detailed reports
    Mail
    E-mail
    Fax
    Annual basis
    Request only

  11. Please list any additional comments, identify strengths, weaknesses, threats, and opportunities available to Schuylkill Rehabilitation Center which will assist our ongoing quest to improve our quality of services.

Optional:
Name: Phone: