Get the free Upper Extremities Assessment Form 2017.doc

THE McKenzie INSTITUTE UPPER EXTREMITIES ASSESSMENT Date Names/Address Telephone Date of BirthAgeReferral: GP / North / Self / Other Work: Mechanical stressesLeisure: Mechanical stresses Functional

How to fill out upper extremities assessment form

How to fill out upper extremities assessment form

1. Step 1: Start by obtaining the upper extremities assessment form from the authorized source.
2. Step 2: Read the instructions carefully to understand the requirements and purpose of the form.
3. Step 3: Begin with filling out the patient's personal details such as name, date of birth, and contact information.
4. Step 4: Provide relevant medical information, including any pre-existing conditions or injuries related to the upper extremities.
5. Step 5: Proceed to assess the range of motion, strength, and dexterity of the upper extremities.
6. Step 6: Use the provided scales or rating systems to accurately evaluate the patient's abilities and limitations.
7. Step 7: Ensure to document any pain or discomfort experienced by the patient during the assessment.
8. Step 8: If applicable, record the results of any diagnostic tests or imaging studies related to the upper extremities.
9. Step 9: Summarize the findings and provide recommendations for further treatment or rehabilitation if necessary.
10. Step 10: Review the completed form for any errors or missing information before submitting it as required.

Who needs upper extremities assessment form?

1. The upper extremities assessment form is typically required for individuals who have experienced injuries or conditions affecting their arms, shoulders, wrists, or hands.
2. This form may be used by healthcare professionals, therapists, or evaluators involved in the diagnosis, treatment, or rehabilitation of such individuals.
3. It is also commonly utilized in occupational or physical therapy settings to gauge progress and determine the appropriate therapeutic interventions.

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What is upper extremities assessment form?

The upper extremities assessment form is a document used to evaluate and document conditions affecting the upper limbs, including the shoulders, arms, elbows, wrists, and hands.

Who is required to file upper extremities assessment form?

Individuals who are experiencing issues or complications related to their upper extremities that require evaluation or reporting may be required to file this assessment form.

How to fill out upper extremities assessment form?

To fill out the upper extremities assessment form, follow the instructions provided on the form, which typically include entering personal information, detailing symptoms or conditions, and providing medical history related to the upper extremities.

What is the purpose of upper extremities assessment form?

The purpose of the upper extremities assessment form is to systematically collect information about upper limb conditions to aid in diagnosis, treatment planning, and documentation for medical or occupational purposes.

What information must be reported on upper extremities assessment form?

The form generally requires personal identification details, descriptions of symptoms, medical history, previous treatments, and any relevant work-related information.