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Doctor
Finder Checklist |
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Background
Information
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| 1. |
What type of license
and certification does the doctor have? |
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| 2. |
Is the doctor Board
Certified, Board Eligible? |
Yes No |
| 3. |
Does the doctor have special
training in brain injury? |
Yes No |
| 4. |
Is the doctor's license current, has it ever
been suspended? |
Yes No |
| 5. |
Is the doctor in good standing with professional
organizations? |
Yes No |
| 6. |
Is the doctor viewed favorably by the medical
and rehabilitation
professional community outside the program
? |
Yes No |
| 7. |
Is the doctor affiliated with any area hospitals? |
Yes No |
| 8. |
Does the doctor carry malpractice insurance? |
Yes No |
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TBI
Expertise & diagnostic Tests
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| 1. |
How much experience do you have treating
cases like mine? |
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| 2. |
When was your practice founded, what is its
guiding philosophy? |
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| 3. |
Will you spend time with me and my and family
to truly understand
our needs? |
Yes No |
| 4. |
What sources of funding /payment plan do you
accept? |
Yes No |
| 5. |
Are treatments custom-tailored to individual
client's needs? |
Yes No |
| 6. |
Which diagnostic tests will you employ in my
case? Why? |
Yes No |
| 7. |
What are they designed
to reveal? |
Yes No |
| 8. |
Will you review the results
with me? |
Yes No |
| 9. |
Are such tests painful
or disorienting? |
Yes No |
| 10. |
Will I need an escort
following such tests? |
Yes No |
| 11. |
Will you provide patient
education materials, and written instructions? |
Yes No |
| 12. |
Will the diagnostic evaluation include a thorough
review of past
medical/rehabilitative care and treatment? |
Yes No |
| 13. |
Will you get previous medical, school records,
other information that
might be needed to evaluate my case? |
Yes No |
| 14. |
Will the evaluation include objective, quantifiable
goals for the
treatment to be evaluated against? |
Yes No |
| 15. |
Will the evaluation specify the length of time
the treatment would take to
accomplish the goals stated in the evaluation? |
Yes No |
| 16. |
Will the evaluation include a detailed projection
of program cost and
outcome goals? |
Yes No |
| 17. |
Is my condition the type
that you commonly treat? With what results? |
Yes No |
| 18. |
What type of program options and / or support
services are available for
my family? Will they need special training regarding my return home? |
Yes No |
| 19. |
How will this treatment support me in my return
to work. |
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| 20. |
Will you arrange for me and my family to speak
with former patients? |
Yes No |
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Treatment
& Patient Care
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| 1. |
What is your approach
to treatment? |
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| 2. |
How do you view my role
in treatment? |
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| 3. |
What are my rights & responsibilities?
Do you have a written policy?
May I have a copy? |
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| 4. |
Do you have a procedure for receiving and resolving
patient and family
complaints concerning the quality of care? |
Yes No |
| 5. |
Are you willing to help
me appreciate and manage my condition? |
Yes No |
| 6. |
How should I prepare
for our appointments? |
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| 7. |
May I expect reminder
calls prior to our appointments? |
Yes No |
| 8. |
What type of treatments
do you anticipate in my case? |
Yes No |
| 9. |
What are the relative
risks of such treatments? |
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| 10. |
Will you provide all of my evaluation and treatments
yourself? |
Yes No |
| 11. |
What are the qualifications of other staff
who provide such
evaluation and treatments? |
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| 12. |
If equipment, is used in procedures, are staff
properly trained to use and care
for the equipment? |
Yes No |
| 13. |
How often is the procedure is performed?
With what success? |
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| 14. |
How long after treatment
begins can I expect to notice improvement? |
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| 15. |
What form will such improvements
take? |
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| 16. |
Are such improvements
gradual or sudden? |
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| 17. |
When will I feel like
myself again? |
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| 18. |
Are such improvements
measurable? |
Yes No |
| 19. |
What will you use to
measure them? |
Yes No |
| 20. |
Does such treatment involve
pain or discomfort? |
Yes No |
| 21. |
Are such treatments very time consuming?
How so? |
Yes No |
| 22. |
Can the treatments be performed at home? |
Yes No |
| 23. |
Can treatments be self administered?
Or do they require assistance?
Are they difficult to learn? |
Yes No |
| 24. |
What are the side effects
of such treatments? |
Yes No |
| 25. |
Should I discontinue
treatment if side effects appear? |
Yes No |
| 26. |
Are such side effects
permanent or temporary? |
Yes No |
| 27. |
What are the costs for
treatment? |
Yes No |
| 28. |
What is the length of
treatment? |
Yes No |
| 29. |
How will missed appointments
be billed. |
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| 30. |
Will I have access to
my medical file upon request? |
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| 31. |
Will you coordinate my
care with other doctors? |
Yes No |
| 32. |
Will I be given periodic progress reports,
and detailed cost statements? |
Yes No |
| 33. |
Will the treatment be adjusted to reflect progress
and / or setbacks |
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| 34. |
Will you develop a discharge plan to ensure
appropriate community
re-integration after
I leave your care? |
Yes No |
| 35. |
How do you choose the other programs, agencies
or individuals to
whom you refer patients? |
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| 36. |
How will you preserve
the confidentially of communication between us? |
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| 37. |
Under what circumstances is specific patient
information released? |
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Sensibilities
& General Impressions
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| 1. |
Demeanor, attitude, appearance
of doctor and staff? |
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| 2. |
Are the buildings and grounds suitable to the
nature of the services
provided to the patients served? |
Yes No |
| 3. |
Office decor, lighting,
atmosphere? |
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| 4. |
Timely service, friendly,
helpful staff |
Yes No |
| 5. |
Did doctor & staff
seem knowledgeable about your condition? |
Yes No |
| 6. |
Does s/he have trial
or personal injury claims resolution experience?
With what success? |
Yes No |
| 7. |
Willingness and /or qualifications
to testify for you? |
Yes No |
| 8. |
Did s/he seem to care
about you as a person? |
Yes No |
| 9. |
Were your questions answered
to your satisfaction? |
Yes No |
| 10. |
Were answers provided
in terms that you understood? |
Yes No |
| 11. |
Were billing cycles or
payment plans discussed with you? |
Yes No |
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