Patient Name Date TMD Disability Index Questionnaire 2026

Get Form
Patient Name Date TMD Disability Index Questionnaire Preview on Page 1

Here's how it works

01. Edit your form online
Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out Patient Name Date TMD Disability Index Questionnaire with our platform

Form edit decoration
9.5
Ease of Setup
DocHub User Ratings on G2
9.0
Ease of Use
DocHub User Ratings on G2
  1. Click ‘Get Form’ to open the Patient Name Date TMD Disability Index Questionnaire in the editor.
  2. Begin by entering your name and the date at the top of the form. This personal information is essential for tracking your responses.
  3. Proceed to Section 1, which focuses on Communication. For each statement, select the one that best describes your experience by checking the corresponding box.
  4. Continue through Sections 2 to 10, which cover various aspects of daily living and well-being. Carefully read each statement and mark your response based on your current condition.
  5. After completing all sections, calculate your total score as indicated at the end of the questionnaire. This score will help assess your level of disability.
  6. Finally, sign and date the form at the bottom to confirm that all information provided is accurate.

Start using our platform today for free to easily fill out and manage your TMD Disability Index Questionnaire!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
Contact us
The NDI has become a standard instrument for measuring self-rated disability due to neck pain and is used by both clinicians and researchers. Each of the 10 items scores from 0 to 5. The maximum score is 50. The obtained score can be multiplied by two to produce a percentage score.
In our original publication we suggested that a score of 0% to 20% represented minimal disability; 20% to 40%, moderate disability; 40% to 60%, severe disability; 60% to 80%, crippled. We felt scores of 80% to 100% reflected either an exaggerated response or the respondent was almost certainly bedbound.
The 8 scores of the 8 sections are summed and divided by 8. The result is the DI or FDI, the disability index or functional disability index. In the event that one section is not completed by a subject then the summed score would be divided by 7.

Security and compliance

At DocHub, your data security is our priority. We follow HIPAA, SOC2, GDPR, and other standards, so you can work on your documents with confidence.

Learn more
ccpa2
pci-dss
gdpr-compliance
hipaa
soc-compliance