Get Aori Clinical Patient Survey Form - Anderson Orthopaedic

This guide provides clear and supportive instructions for completing the AORI Clinical Patient Survey Form online. Your careful and accurate responses will contribute to the quality of care provided by the Anderson Clinic.

Follow the steps to complete the form effortlessly.

1. Press the ‘Get Form’ button to obtain the form and open it in your viewing application.
2. Begin with Section 1, where you will fill in your personal information. Include your name, address, phone numbers, date of birth, social security number, sex, weight, and height.
3. Section 2 focuses on pain assessment. Specify the amount of pain you normally experience and how often you have pain. Choose the appropriate options by marking the box next to your selected answer.
4. Indicate how often you take medication for pain and specify the types of medications you use. Select all that apply.
5. Reflect on how much of your health problems are due to your hip and select the answer that best describes your situation.
6. Indicate where you feel pain and choose your living situation from the options provided.
7. Answer the questions regarding your ability to use public transportation.
8. Move to the function/level of activity section and assess each hip's level of function as well as the types of activities you are capable of doing.
9. Evaluate your ability to go up stairs and how long you can walk without support, then describe your current work status.
10. Assess any difficulties you have in putting on shoes and socks, and indicate how long you can sit comfortably.
11. Finally, that you may need support when walking and indicate how far you can walk without stopping due to hip pain.
12. After completing all necessary sections, you can save your changes, download the form, print it, or share it as needed.

Complete your form online today for a better understanding of your hip health.