2019 RI Lifespan Comprehensive Spine Center Follow-Up Patient Questionnaire-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your personal information, including your name and date of birth, in the designated fields at the top of the form.
3. Proceed to fill out your height, weight, blood pressure, and pulse. This information is crucial for your healthcare provider.
4. Indicate whether this is a workman’s compensation issue by selecting 'Yes' or 'No'.
5. Answer questions regarding your pain location and intensity. Use the scale provided (0-10) to describe how bad your pain is on average.
6. Complete the Oswestry Score section by circling the appropriate responses that best describe your pain and its impact on daily activities.
7. In the Review of Systems section, circle 'Yes' or 'No' for each item listed and provide explanations where necessary.
8. Finally, review all entries for accuracy before saving or submitting your completed questionnaire.

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