| Questions | Answer | ||||
| 5 | 4 | 3 | 2 | 1 | |
| 1) How satisfied are you with how your pain was controlled in the hospital after surgery? | Very satisfied | Satisfied | Neutral | Unsatisfied | Very unsatisfied |
| 2) How satisfied are you with how your pain was controlled at home after surgery? | Very satisfied | Satisfied | Neutral | Unsatisfied | Very unsatisfied |
| 3) How satisfied are you with the amount of time it took for you to return to your normal activities e.g., housework or social activities outside the home? | Very satisfied | Satisfied | Neutral | Unsatisfied | Very unsatisfied |
| 4) How satisfied are you with the amount of time it took for you to work? | Very satisfied | Satisfied | Neutral | Unsatisfied | Very unsatisfied |
| 5) How satisfied are you with the amount of time it took for you to return to your normal exercise routine? | Very satisfied | Satisfied | Neutral | Unsatisfied | Very unsatisfied |
| 6) Did you develop any complications following your surgery? |
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| 7) How satisfied are you with the results of your surgery? | Very satisfied | Satisfied | Neutral | Unsatisfied | Very unsatisfied |
| 8) Looking back, if you had “to do it all over again”, would you have the surgery? | Absolute yes | I guess yes | Neutral | Don’t think so | Never |
| 9) Would you recommend this surgery to someone else? | Absolute yes | I guess yes | Neutral | Don’t think so | Never |
| 10) On a score of 0 to 20 where 0 is the worst level of health you can have, where 10 means you feel your health levels are average following surgery and 20 means you are in the best possible health since surgery, how would you score your current health levels? |
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