Follow up patient questionnaire:

Please click on the link below to open the discharge patient questionnaire. It can be done on your computer or mobile phone. The information collected is invaluable for our practitioners in providing the best possible care for your chronic pain problem.

The questionnaire is in two parts, so please make sure both parts are completed. The questionnaire will take you 45-60 minutes to complete. Take your time and answer each question as accurately as you can.

If you need a break, ensure you leave your browser window open. If you close the browser window or shut down your computer/phone, YOU WILL LOSE ALL THE ANSWERS and have to start the questionnaire again.

Please finalise and SUBMIT the questionnaire at least 12 hours prior to your discharge pain management appointment. We cannot continue to assist you with your pain problem until this questionnaire is completed.

There are some repeated questions through this questionnaire. This is unavoidable to ensure the information from the questionnaire is accurate. Sometimes none of the answer options are completely accurate. In this situation pick the BEST answer.

You need to provide an answer for ALL questions to complete the questionnaire.

If there are any problems completing the questionnaire please contact info@advancehealthcare.com.au or contact your practitioner.

Once you have completed this questionnaire please move to the next part of the process by clicking the button below.