Physical and Occupational Therapy Clinic Software Solution Survey
*
1.
Your Name
(Required.)
2.
Your Clinic Role/Title
3.
Name of the Clinic
4.
URL of your Clinic/Practice, if any
*
5.
Your Email
(Required.)
6.
Your Phone
7.
What services are offered in the Clinic?
Rehabilitation Services
Wellness Services
Physical Therapy
Occupational Therapy
All of the above
Other (please specify)
8.
Select all the services
offered
Manual therapy
Sports Rehabilitation
Vestibular and Balance Rehab
Orthopedic Rehab : Head & Neck, Both Extremities, Thoracic Spine, Lumbar Spine & Pelvis, General
Geriatrics
Pediatrics
Pain Management
Neurological Rehab: Stroke, Gait and Balance
Graston Technique
Cupping Therapy
Trans-cutaneous Electrical Nerve Stimulation (TENS)
Therapeutic Ultrasound
Other (please specify)
*
9.
What Software and Software Services are used to support Clinic patient activities? Select all that apply with level of satisfaction
(Required.)
Not Used
Very Dissatisfied
Dissatisfied
Neither Satisfied not Dissatisfied
Satisfied
Very Satisfied
Website solution
Not Used
Very Dissatisfied
Dissatisfied
Neither Satisfied not Dissatisfied
Satisfied
Very Satisfied
EMR Solution
Not Used
Very Dissatisfied
Dissatisfied
Neither Satisfied not Dissatisfied
Satisfied
Very Satisfied
CRM Solution
Not Used
Very Dissatisfied
Dissatisfied
Neither Satisfied not Dissatisfied
Satisfied
Very Satisfied
Office 365 Solution
Not Used
Very Dissatisfied
Dissatisfied
Neither Satisfied not Dissatisfied
Satisfied
Very Satisfied
Other (please specify)
10.
What Web Site Capabilities are being used in the Clinic?
Mobile friendly
Desktop and Tablet friendly
Staff Bios
Key Products and Services
Case Studies
Videos on Services
Images of the Clinic
Patient Educational Content and Blogs
FAQ Section
Online Scheduling Services
Online Chat Services
Patient Billing
Patient Portal
Other (please specify)
11.
What additional website capabilities would be a value-add for the clinic?
12.
What EMR Capabilities are being used in the Clinic?
Patient Registration
Previsit forms
Schedule Management
Medical Record Management: Allergies, Care Plans, Social and Family History
Record Clinical Encounters/Clinical Documentation
Lab and Diagnostic Test Management
Medications Management
Reminders and Alerts
Referrals
Billing
Patient Portal
Online video consults and followups
Other (please specify)
13.
What additional EMR capabilities would be a value-add for the clinic?
14.
What CRM Capabilities are being used in the Clinic?
Patient Database
Referral Provider Database
Role based access
Intelligent Mail Campaigns
Appointment Reminders
Reports and Dashboards
Integration with EMR and other Billing software
Predictive Analytics
Dashboards and Reports
Other (please specify)
15.
What additional CRM capabilities would be a value-add for the clinic?
16.
What Office 365 Capabilities are being used in the Clinic?
Email
Outlook
Content and Records Management
Calendar
Communications with clinic staff
Clinical Reporting and Dashboards
Conference Calls for Business
Word
Excel
Powerpoint
Other (please specify)
17.
What additional Office 365 capabilities would be a value-add for the clinic?
18.
How do you rate the Clinic’s current Software Services and Hosting provider?
Rate as 1-5 with 5 as highest level
1 star
2 stars
3 stars
4 stars
5 stars
Other (please specify)
19.
Would you like Star Knowledge to conduct an initial free analysis on your current website and provide you with inputs? The report would include opportunities by which you could use digital marketing to drive more patients to your clinic.
Yes
No
Maybe
