Purpose: The purpose of the referral is to improve the quality and efficiency of patient care within the IDHI Stroke Program system in Arkansas. This form is intended to relay both positive and negative comments regarding Stroke Patient Care in the IDHI Stroke Program system of care. Submission of this document triggers further review of a specific incident. All information obtained through this process will remain confidential. This information will be used for improving patient care and will not be used as a punitive tool.