Get Upper Imb Assessment Sheet

The Upper Imb Assessment Sheet is an essential document used for evaluating upper extremity impairments. This guide provides clear, step-by-step instructions on how to fill out the form online, ensuring you complete it accurately and efficiently.

Follow the steps to fill out the Upper Imb Assessment Sheet online.

1. Click the ‘Get Form’ button to access the Upper Imb Assessment Sheet and open it for filling out.
2. Begin by entering your personal information, including your name, age, occupation, sex, and dominant hand. Specify whether it is right or left.
3. Enter the date of evaluation and your diagnosis, if applicable. Make sure to include any abnormal motion or other disorders you are experiencing.
4. For each joint – wrist, elbow, and shoulder – record the angle of motion and corresponding impairment percentage. Ensure you accurately assess flexion, extension, and other relevant movements.
5. For amputations and other impairments, clearly indicate the type of impairment and add the impairment percentages as instructed.
6. Complete the calculations for regional impairment by combining the impairment percentages from the hand, wrist, elbow, and shoulder sections.
7. If both limbs are involved, calculate the whole person impairment using the provided charts for each upper extremity.
8. Review all entries for accuracy, then save your changes. You can choose to download, print, or share the completed form.

Complete your Upper Imb Assessment Sheet online today!