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How to use or fill out Patient Name Date Knee Outcome Survey Activities of with our platform
- Click ‘Get Form’ to open it in the editor.
- Begin by entering your name in the 'Patient Name' field. This personalizes the survey and ensures accurate record-keeping.
- Next, input the date in the 'Date' field. This helps track when the survey was completed.
- For the Knee Outcome Survey Activities of Daily Living Scale (ADLS), rate your physical function by selecting a score from 0 to 5 for each activity listed. Use the provided scale to reflect your current abilities.
- Once you have completed all ratings, calculate your total score and enter it in the 'Total Score' field. This percentage reflects your overall physical function.
- If you are a Medicare patient, complete the additional section by calculating your function and impairment percentages based on your total score.
- Finally, sign and date both the 'Patient Signature' and 'Therapist Signature' fields to validate the document.
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