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* 1. Who was the clinician providing your service?

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* 2. What is your age?

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* 3. Demographics

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* 4. What is your ethnic background?

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* 5. Which region do you live in?

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* 6. How satisfied were you in your level of involvement in the development of your plan?

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* 7. Overall, how well do you think we coordinated with your GP, employer, other treatment providers and rehabilitation specialists?

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* 8. Did you have any cultural needs that you needed taken into consideration?

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* 9. If you answered Yes to the above, how well do you feel we considered your cultural needs?

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* 10. Overall, how satisfied are you with the services that you received from us?

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* 11. How easy were your programme plans and reports to understand?

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* 12. How much did the service to you help in achieving a good outcome?

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* 13. How likely is it that you would recommend Southern Rehab to a friend or colleague?

Not at all likely
Extremely likely

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* 14. Please provide any general comments you may wish to make, regarding the rehabilitation or services received?

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* 15. If you would like to be contacted regarding any of your responses in this survey, please provide your contact details below

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