FOR PATIENTS

**Scar Release QI* Survey**

*Quality Improvement

As part of your scar treatment plan please complete the short survey one week after your scar release treatment.

Your participation is completely voluntary.
No identifying information is asked.
The aggregate data of these surveys will be used to help practitioners evaluate the effectiveness of scar release treatment

Thank you!

There are two ways to access the QI survey:

Direct link:

https://www.surveymonkey.com/r/Z72P9QK

Scan the QR Code:

QR code that can be scanned with a smartphone to access a survey

In the survey you will be asked to complete the PEG (Pain, Enjoyment of Life and General Activity) Scale questionnaire both for how your felt before and 1 week after your scar release.

The questions asked will be similar to those in the table below.