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Initial Functional Assessment Questionnaire Patient Name: D.O.B: ACCT#: MR#:James R. Gage Center for Gait and Motion Analysis Thank you for your assistance. If you need help or have any questions,
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Start by reading the instructions and questions carefully.
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Make sure you understand the purpose of each question and what information it is asking for.
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Use a pen or pencil to fill out the questionnaire.
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Answer the questions honestly and to the best of your ability.
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If there is a question that does not apply to you or that you are unsure about, leave it blank or mark it as N/A.
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Double-check your answers before submitting the questionnaire.
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If you are unsure about any part of the questionnaire or need assistance, don't hesitate to ask for help from a healthcare professional or someone who is familiar with the questionnaire.

Who needs gillette functional assessment questionnaire?

01
The Gillette Functional Assessment Questionnaire is commonly used by healthcare professionals, specifically in the field of physical therapy, rehabilitation, and orthopedics.
02
Individuals who have mobility or functional limitations due to musculoskeletal conditions, physical disabilities, or injuries may need to fill out this questionnaire.
03
It helps assess the functional abilities and limitations of the individual, which can aid in developing personalized treatment plans, monitoring progress, and evaluating the effectiveness of interventions.
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The Gillette Functional Assessment Questionnaire is a tool used to assess a child's functional abilities and limitations in various areas such as mobility, self-care, and communication.
Parents or caregivers of children with disabilities are usually required to file the Gillette Functional Assessment Questionnaire.
The Gillette Functional Assessment Questionnaire can be filled out by answering the questions related to the child's abilities and limitations in different functional areas.
The purpose of the Gillette Functional Assessment Questionnaire is to provide healthcare providers with valuable information about a child's functional abilities and limitations.
Information such as the child's mobility, self-care skills, communication abilities, and overall functional limitations must be reported on the Gillette Functional Assessment Questionnaire.
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