Stem Cell

Blank Questionnaire

Patients were asked a series of questions following their procedure, and also at  6 months post injection:

 

How satisfied were you with the treatment?

  1. Not Satisfied
  2. Not Very Satisfied
  3. Neutral
  4. Somewhat Satisfied
  5. Very Satisfied

How satisfied were you with your treatment with staff?

  1. Not Satisfied
  2. Not Very Satisfied
  3. Neutral
  4. Somewhat Satisfied
  5. Very Satisfied

Based upon your experience, would you feel comfortable recommending this procedure to a friend or family member?

  1. Not at all
  2. Not Really
  3. Undecided
  4. Somewhat Comfortable
  5. Very Much so

If warranted, would you have this procedure done again?

  1. Not at all
  2. Not Really
  3. Undecided
  4. Somewhat Interested
  5. Very Much so

Has your function / ADL (activities of daily living) improved?

  1. Worse improvement
  2. No improvement
  3. Minor Improvement
  4. Moderate improvement
  5. Major Improvement

What is your pain relief?

  1. Worse improvement
  2. No improvement
  3. Minor Improvement
  4. Moderate improvement
  5. Major Improvement
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