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* 1. Name of Reviewer

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* 2. Affiliation of Reviewer

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* 3. Daytime Phone

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* 4. E-mail Address

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* 5. Role: (Select all that apply):

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* 6. In your role as a healthcare consumer, practitioner, educator, researcher, claims reviewer, administrator, or policy maker, how would you describe the applicability / usefulness of this guideline. (Select only one)

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* 7. Describe what you found most useful as you read this practice guideline.

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* 8. Describe what you found least useful as you read this practice guideline.

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* 9. Feel free to provide suggestions that you have regarding how to improve the usefulness of this clinical practice guideline:

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* 10. In your role as a healthcare consumer, practitioner, educator, researcher, claims reviewer, administrator, or policy maker, how would you describe the validity of this guideline? (Select only one)

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* 11. If you feel that this guideline misrepresents the peer-reviewed literature, please provide an example of this misrepresentation:

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* 12. In your role as a healthcare consumer, practitioner, educator, researcher, claims reviewer, administrator, or policy maker, how would you describe the impact that this guideline will have on orthopaedic physical therapy patient care. (Select only one)

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* 13. Feel free to describe aspects of orthopaedic physical therapy that will be impacted in a negative manner as a result of this clinical practice guideline. You may also provide your rationale for this position:

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* 14. Feel free to describe aspects of orthopaedic physical therapy that will be impacted in a positive manner as a result of this clinical practice guideline. You may also provide your rationale for this position:

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* 15. Feel free to provide suggestions that you have regarding how to improve the impact of this clinical practice guideline:

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