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Health-Resiliency-Stress Questionnaire (HRSQ) Provider Registration
HRSQ and all versions: copyrighted, all rights reserved (3/2019)

PROVIDERS:
Register to receive easy-to-read, HIPAA-compliant patient/client completed e-HRSQ responses directly into your designated email. (Email can also be a central office email, e.g. reception@DrSmithClinic.com.)

ADMIN:
Create a unique code for each patient/client referred to complete the e-HRSQ. This can be as simple as: Dr.Smith#1, Client#1, A1, etc. Provide your client/patient with the code and the clinic/provider email address; these will be required to complete the e-HRSQ.

ONCE REGISTERED, PROVIDERS can start referring clients/patients and expect:
1) to receive a printable HRSQ form completed by your referred patient/clients

2) that your patient/client's answers will be added to the pool of all other data. No identifying information will be solicited or requested; the ip address of origin and referral code will be scrubbed and not enter into the database (just in case a client/patient may accidentally put in their name or any potentially identifying information)

3) to receive periodic updates on the HRSQ and related health care applications of the HRSQ

4) an invitation to give us feedback on the clinical utility of the HRSQ twice/year. This will be a 1 minute e-survey. (We highly value your input!)

The TRC thanks each provider/clinic who signs up and refers patients/clients to complete the HRSQ.
Healing, health and wellness takes a community!

Name of Work Place
Your answer
Provider Name *
Your answer
Type of Workplace *
Required
Type of Healthcare Provider *
Provider State *
Country *
Your answer
Provider email or general clinic email (e.g. reception@ResilientClinic.com) *
Your answer
How did you hear about the HRSQ project? *
Required
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