Exit this survey
Specialty Hospital Outcome Survey (90 day post-discharge)
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.
1
. Please Choose the time frame for which your child was discharged from the hospital.
2010
January-March 2011
April-June 2011
July-September 2011
October-December 2011
January-March 2012
April-June 2012
Please Choose the time frame for which your child was discharged from the hospital.
*
2
. Please choose the month/year in which your child was discharged from the hospital
January 2011
February 2011
March 2011
April 2011
May 2011
June 2011
July 2011
August 2011
September 2011
October 2011
November 2011
December 2011
January 2012
February 2012
March 2012
Please choose the month/year in which your child was discharged from the hospital
*
3
. How old was your child (in years) when he/she was discharged from the hospital (approximately 3 months ago)?
How old was your child (in years) when he/she was discharged from the hospital (approximately 3 months ago)?
*
4
. Please choose the Hospital where you recently were a patient
AI duPont Hospital for Children (Wilmington, DE)
Children's Hospital of Philadelphia
Children's Specialized Hospital (New Brunswick, NJ)
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
*
5
. Please choose the category of service that 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)
Functional Feeding (includes children admitted primarily for feeding needs, or to transition from tube to oral feeds)
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 all programs that do not fit other categories mentioned)
Please choose the category of service that you received while in the hospital (choose only one)
20%
Javascript is required for this site to function, please enable.