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FUNCTIONAL ASSESSMENT QUESTIONNAIRE Eval/Progess/Discharge Date: Number of Visits: Patient Name: Dx: Using the key below please circle one answer in each box that indicates your ability to do the.

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  1. Click on the Get Form button to start editing.
  2. Switch on the Wizard mode on the top toolbar to obtain additional suggestions.
  3. Fill out every fillable area.
  4. Ensure that the details you add to the Functional Assessment Questionnaire is up-to-date and accurate.
  5. Indicate the date to the record using the Date function.
  6. Select the Sign button and create an electronic signature. You can use 3 available options; typing, drawing, or capturing one.
  7. Double-check every area has been filled in properly.
  8. Click Done in the top right corne to save and send or download the sample. There are many alternatives for getting the doc. An attachment in an email or through the mail as a hard copy, as an instant download.

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