Get Physical Therapy Evaluation Form

Filling out the Physical Therapy Evaluation Form online can be a straightforward process when guided step-by-step. This guide aims to provide clear instructions to ensure you complete the form accurately and efficiently.

Follow the steps to successfully complete the evaluation form.

1. Press the ‘Get Form’ button to access the evaluation form and open it in your chosen editor.
2. Begin by entering your name in the designated field at the top of the form, followed by the date of the evaluation.
3. For question one, circle a number that indicates your least pain experience and another number for your most pain experience.
4. In the section asking for three activities that cause difficulty, list the specific activities that worsen your symptoms.
5. Specify the positions or activities that help reduce your pain in the appropriate field.
6. Detail any improvements you have noticed since starting physical therapy, such as changes in sleep or activity levels.
7. List any medications you have stopped or significantly reduced, specifying the names in the provided fields.
8. If you have started any new medications since your last evaluation, include their names and dosages.
9. Use the shading section to indicate areas of pain and discomfort, darkening those with the greatest discomfort.
10. Provide information on how long you have been taking the specified medications and their frequency of use in the appropriate sections.
11. Evaluate and provide the percentage of overall improvement for each condition since your first visit.
12. Reflect on your home self-care and exercise program, sharing your progress and experiences.
13. Lastly, note any specific inquiries or goals you wish to achieve during this evaluation.
14. Once completed, review your form for accuracy. You can save your changes, download, print, or share the form as required.

Complete your Physical Therapy Evaluation Form online today to enhance your therapy experience.