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Covenant Healthcare 1447 North Harrison Saginaw, MI 48602QUESTIONNAIRE/UPPER EXTREMITY FUNCTIONAL SCALEPF03064 (R7/17)PATIENT I.D. Please indicate if you have any difficulty with the activities listed

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Who needs questionnaireupper extremity?

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The questionnaire upper extremity is designed for individuals who need to assess and provide information specifically related to their upper extremity, which includes the arms, hands, and shoulders. This questionnaire may be needed by patients or individuals undergoing physical therapy, rehabilitation, or medical treatment for upper extremity injuries, conditions, or disorders. It can also be used by healthcare professionals to gather detailed information about the upper extremity of their patients.

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What is questionnaireupper extremity?

The questionnaire upper extremity is a form used to assess the functional capabilities and limitations of an individual's upper limbs, often for medical, insurance, or rehabilitation purposes.

Who is required to file questionnaireupper extremity?

Individuals who have undergone evaluations or treatment related to upper extremity issues, including those involved in workers' compensation claims, are typically required to file the questionnaire.

How to fill out questionnaireupper extremity?

To fill out the questionnaire upper extremity, individuals should carefully read the instructions provided, answer all relevant questions truthfully, and provide any required documentation or additional information as prompted.

What is the purpose of questionnaireupper extremity?

The purpose of the questionnaire upper extremity is to evaluate and document the function of the upper limbs, identify limitations, and aid healthcare professionals in treatment planning.

What information must be reported on questionnaireupper extremity?

Reported information typically includes personal details, a description of the upper extremity condition, functional limitations, pain levels, and treatment history.

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