Get Duffy-rath Questionnaire

The Duffy-Rath Questionnaire is a valuable tool for assessing your current health status and pain levels. This guide will provide you with clear, step-by-step instructions on how to fill out the form online, ensuring a smooth and efficient process.

Follow the steps to complete the Duffy-Rath Questionnaire with ease.

1. Click ‘Get Form’ button to access the Duffy-Rath Questionnaire and open it in your preferred online editor.
2. Begin by filling in the basic information at the top of the form. Enter your name, date, and visit number to ensure accurate record-keeping.
3. On the first side of the questionnaire, indicate your current pain levels by drawing on the figure provided. Use 'X' marks for areas of numbness, tingling, or pins and needles you are experiencing today.
4. Respond to the series of questions regarding your neck, arm, lower back, and leg pain by circling the number that corresponds to your symptoms today, selecting from a scale of 0 to 10.
5. Similarly, assess your functional abilities by rating how well you can sit, stand, walk, bend, lift, and carry. Circle the number that best agrees with your abilities today across these different activities.
6. Once you have filled out both sides of the questionnaire accurately, review your responses to ensure completeness and accuracy.
7. Finally, save your changes and choose to download, print, or share the completed questionnaire as needed.

Begin completing your documents online today for a smoother healthcare experience.