functional rating index scoring Preview on Page 1

Functional rating index 2026

Here's how it works

  • 01. Edit your functional rating index scoring 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 functional rating index via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out functional rating index 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 functional rating index in the editor.
  2. Begin with the 'Pain Intensity' section. Circle the number that best describes your current pain level, ranging from 0 (no pain) to 4 (worst possible pain).
  3. Proceed to the 'Sleeping' section. Indicate your sleep quality by circling a number from 0 (perfect sleep) to 4 (totally disturbed sleep).
  4. In the 'Personal Care' section, assess how your condition affects daily activities like washing and dressing. Choose a number from 0 (no pain; no restrictions) to 4 (severe pain; need 100% assistance).
  5. Continue through each section, including 'Work', 'Lifting', and 'Walking', circling the appropriate numbers based on your experiences.
  6. Once all sections are completed, review your selections for accuracy before signing and dating at the bottom of the form.

Start using our platform today for free to complete your functional rating index effortlessly!

be ready to get more

Complete this form in 5 minutes or less

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.

back pain functional scale pdf

Functional rating index: a new valid and reliable instrument

by RJ Feise 2001 Cited by 452 The Functional Rating Index is a self-reporting instrument consisting of 10 items, each with 5 possible responses that express graduating degrees of disability.Read more

Learn more
If you believe that this page should be taken down, please follow our DMCA take down process here