Because patients reported concerns regarding the adequacy of pastoral service delivery during their inpatient rehabilitation hospitalization, a study was performed to ascertain the patient's pastoral needs and the extent of pastoral services provided. After discharge from the inpatient rehabilitation hospital, patients were surveyed as to their perceived religious and spiritual needs, as well as to the extent of religious, spiritual, and pastoral services provided during their inpatient stay. The majority of responders (74%) reported their religious and spiritual beliefs were important. Forty-five percent of responders indicated not enough attention was repaid to their religious or spiritual needs, whereas only 1% felt that too much attention was paid. A majority of patients (54%) desired pastoral visitation. Other needs were elicited, including expanded pastoral services, increased staff empathy for the patient's spiritual and religious needs, and improved availability of church or synagogue services or sacraments. Many Jewish patients reported concerns of being punished by God, whereas Christian patients were concerned that God was unaware of their personal needs. Some responders, regardless of personal faith, were also troubled with fears of death, God's failure to heal, and loss of purpose in life. There is a clear need to establish a mechanism to identifying the religious and spiritual needs of each individual patient. These needs must be considered with both sensitivity and compassion by all members of the rehabilitation staff. The rehabilitation facility must also develop a mechanism to identify pastoral care resources available within the hospital and local community, and to assure that the patient's needs are addressed.