Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Healthcare discipline
*
Medicine - neurology/pediatrics/psychiatry etc.
Chiropractic
Functional Neurology/Clinical Neurocience
Occupational Therapy
Speech Therapy
Physical Therapy
CBT (cognitive behavioral therapy)
Educator - corrective learning/special education etc.
Other
I was referred by:
*
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How do you prescribe home exercises/therapy? (check all that apply)
*
I don't give home exercises
Oral explanation
Pre-made paper instructions sheets/booklets
personalized paper instructions sheets
email/instant message video explanations/examples
Online explanation/examples
Other
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How do you monitor home exercises compliance?
*
I don't monitor home exercises
Oral report by patient
Written report (paper)
Email/instant message report by patient
Online tracking system
Video recording sent by the patient
Other
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How likely are you to use an online system that provides both home exercises tool and a compliance tools?
*
1
2
3
4
5
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What kind of information is important for you, when tracking home compliance?
*
Did the patient perform the exercises
Did they perform the prescribed amount/frequency
How well did they perform
Did they encounter difficulties?
What were their difficulties?
Is there a progression/regression trend?
Other
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How often would you like to get tracking information?
*
Whenever the patient performed an exercise
Once a day
Once a week
Once a month
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How should you like to communicate with your patients?
*
Video
On-Line chat
Off-line chat
One-way messaging
I do not need to communicate with my patients
I'm happy with the current state
Other
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How can we help you make sure your patients do the exercises you perscribe?
*
Submit
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