Specialty Hospital Satisfaction Survey
1. General Information
The following short survey will ask several questions about the care that you received while in the hospital and after discharge. Your feedback helps us to improve program quality and the processes through which care is delivered. We appreciate your comments and respect your opinions. Please answer the questions honestly, and provide additional comments at the end of the survey. Thank you.
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1
. Please choose the month/year in which your child was discharged from the hospital
March 2009
April 2009
May 2009
June 2009
July 2009
August 2009
September 2009
October 2009
November 2009
December 2009
January 2010
February 2010
March 2010
April 2010
May 2010
June 2010
Please choose the month/year in which your child was discharged from the hospital
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2
. How old was your child (in years) when he/she was discharged from the hospital (about 3 months ago)?
How old was your child (in years) when he/she was discharged from the hospital (about 3 months ago)?
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3
. Please choose the Hospital where you recently were a patient
AI duPont Hospital for Children (Wilmington, DE)
Children's Hospital of Philadelphia
Good Shepherd Hospital (Allentown, PA)
Kennedy Krieger Institute (Baltimore, MD)
The Children's Institute (Pittsburgh, PA)
Weisman Children's Rehabilitation Hospital (Marlton, NJ)
Please choose the Hospital where you recently were a patient
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4
. Please choose the category of service you received while in the hospital (choose only one)
Brain or Neurological Injury (includes traumatic brain and closed head injuries)
Spinal Cord Injury (includes all illnesses and injuries involving the spine)
Developmental Delay (includes children admitted for developmental disabilities such as cerebral palsy)
Chronic Pain (includes Reflex Neurovascular Dystrophy (RND), arthritis, and programs specifically designed to treat pain)
Orthopaedic (includes broken bones, post surgical programs to increase movement such as tendon lengthening)
General (includes programs to address feeding, and all programs that do not fit other categories mentioned)
Please choose the category of service you received while in the hospital (choose only one)
20%
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