Lower extremity functional form 2026

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The document is a Lower Extremity Functional Scale (LEFS) questionnaire designed to assess a patient's difficulty with various activities due to lower limb problems. It includes a list of activities and asks patients to rate their level of difficulty, providing a total score that reflects their functional status.

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Click ‘Get Form’ to open the lower extremity functional form in the editor.
Begin by entering your name in the designated field at the top of the form. This personalizes your submission and ensures accurate tracking.
Review each activity listed in the form carefully. For each activity, select one of the difficulty levels: 'No Difficulty', 'A Little Bit of Difficulty', 'Moderate Difficulty', 'Quite a Bit of Difficulty', or 'Extreme Difficulty or Unable to Perform Activity'.
Continue through all 20 activities, providing your response for each. This will help assess your lower limb functionality effectively.
Once you have completed all sections, check the total score section at the bottom. Ensure that your scores are accurately totaled for a comprehensive overview.

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