Patient Telehealth Impact Survey

The American Physical Therapy Association – Colorado Chapter (APTA CO) is gathering information on patient experiences with telehealth as provided by a physical therapist. Your input will help guide regulatory activity and practice guidelines for the current and future use of telehealth by physical therapists and physical therapist assistants. Please be assured that your information will be submitted anonymously. We sincerely appreciate your time and participation!

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* 1. Please provide your age range

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* 2. For what condition/injury have you received telehealth management?

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* 3. Have you received telehealth before?

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* 4. Who is providing coverage for your care?

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* 5. Please outline improvements in pain or function that you have received.

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* 6. Please provide a brief 2-3 sentence testimonial on your experience.

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* 7. Was the experience what you expected? Why or Why not?

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* 8. On a scale of 1 to 10,  how likely are you to use telehealth services again?

Least Likely Highly Likely
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 9. On a scale of 1 to 10, how likely are you to recommend telehealth to others?

Least Likely Highly Likely
Clear
i We adjusted the number you entered based on the slider’s scale.

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