Follow the steps to complete the Mckenzie Assessment Form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the date at the top of the form. This helps document when the assessment takes place.
3. Fill in your personal information such as name, sex, address, telephone number, date of birth, and age. Ensure accuracy for effective communication and follow-up.
4. Indicate your referral source by selecting whether it is from a general practitioner, orthopedist, self-referral, or other sources.
5. Complete sections related to postures, stresses, and functional disability. Estimate the functional disability score and the Visual Analog Scale (VAS) score from 0 to 10.
6. In the history section, describe your present symptoms, including when they started and characterize their nature—improving, unchanging, or worsening.
7. Record any relevant information about your symptoms at onset, including what worsens or alleviates the discomfort.
8. Complete the treatment history for this episode and any previous treatments you have undergone. Include details about medications, their effects, and your general health condition.
9. Proceed to the examination section. Document your observations, baseline measurements, and responses to movements, both active and passive.
10. Identify any provisional classification of your condition. Choose the applicable categories, such as dysfunction or derangement, based on your assessments.
11. Outline your principle of management, including education, exercise, and treatment goals. Specify how often your treatment should occur.
12. Finally, review all provided information for accuracy, then save changes, download, print, or share the completed form as needed.

Complete your Mckenzie Assessment Form online with confidence by following these steps.