Survey of Specialty Areas
First Name:
Last Name:
Organization:
Phone:
Address:
City:
State:
Zip:
What does your facility offer?
Children's
Stroke
Cardiac
Pulmonary
Cancer
Transplant
Joint replacement
Amputation
Osteoarthritis
Rheumatoid arthritis
Hip fracture
Neurological condition
Spinal cord injury
Brain injury
Burn
Physical therapy
Occupational therapy
Speech therapy
Therapeutic recreation
Pain management
Guillain-Barre syndrome
Cerebral palsy
Congenital defects
What type of Facility are you?
Comprehensive Outpatient Rehabilitation Facility
Long Term Acute Care Hospital
Skilled Nursing Facility
Inpatient Rehabilitation Unit
Freestanding Rehabilitation Hospital
How many beds does your facility have?
Number of total licensed beds (total number of beds for units)
Number of Medicare excluded beds
Is your facility an AMRPA member organization?
Yes
No
What private foundations does your facility work with?
Complete this form by clicking the “Submit” button below.
Rebecca Schnorf
rschnorf@hso.net
.
Phone: (217) 753-1190