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Get 6 Minute Walk Test Form
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How to fill out the 6 Minute Walk Test Form online
The 6 Minute Walk Test Form is an essential tool for clinicians conducting a comprehensive assessment of lung function. This guide provides step-by-step instructions to help users navigate the process of filling out the form online with ease and confidence.
Follow the steps to complete the form online efficiently.
- Press the 'Get Form' button to acquire the form and open it in your preferred online editor.
- Begin filling out the header information. Enter the FORM DATE using the provided pop-up calendar or type the date in the mm/dd/yyyy format. Also, input the INITIALS for the staff member entering the information.
- In Item 1, indicate whether medications were taken since the post-bronchodilator spirometry by entering 'Y' for Yes or 'N' for No. If you answer Yes, provide details of up to 3 medications, including the name, dose, and the time taken in hours and minutes.
- For Item 2, specify if blood pressure was recorded more than 4 hours prior to the 6 Minute Walk Test by selecting 'Y' for Yes or 'N' for No. If Yes, fill out the systolic and diastolic pressures.
- In Item 3, record whether supplemental oxygen was used during the test by entering 'Y' for Yes or 'N' for No. If Yes, include the oxygen flow rate in Liters per minute and specify the type of oxygen delivery system.
- Item 4 requires recording the SpO2 at rest prior to the test as a percentage, along with the pulse in beats per minute.
- Proceed to Item 5 and indicate if continuous oximetry was recorded by marking 'Y' for Yes or 'N' for No.
- For Item 6, document the start time of the 6-minute walk in hours and minutes, indicating AM or PM.
- Immediately following the walk in Item 7, record the SpO2 and pulse again, along with the participant's breathlessness and exertion levels using the provided scales.
- Finalize by filling out Item 8 with course type and completed lap data. For Item 9, indicate if the participant stopped before 6 minutes by marking 'Y' or 'N'. If Yes, provide the duration and reason for stopping in Items 9a and 10.
- Finally, review the completed form for accuracy, then save changes, download, print, or share the form as needed.
Take the next step in your process by completing documents online.
Calculating the results of a 6 Minute Walk Test is straightforward. Simply measure the total distance walked during six minutes and record it on the 6 Minute Walk Test Form. This single measurement is key in assessing the individual's physical fitness level and can be compared to standard benchmarks for comprehensive insights.
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