Get Shoulder Assessment Form

Completing the Shoulder Assessment Form is an important step in evaluating your shoulder health. This guide provides clear, step-by-step instructions to help you accurately fill out the form online.

Follow the steps to successfully complete the Shoulder Assessment Form.

1. Press the 'Get Form' button to access the Shoulder Assessment Form and open it in your preferred online editor.
2. Begin filling in your name and date in the designated fields at the top of the form. Ensure that the date is formatted correctly.
3. Input your age in the corresponding field. This information is crucial for healthcare providers to assess your shoulder condition appropriately.
4. Specify your sex by selecting the appropriate option: Male or Female. Also indicate which shoulder is injured: Right, Left, or Both.
5. Indicate your hand dominance by selecting either Right or Left. This detail helps doctors understand the potential impact of the injury on your daily activities.
6. Enter the date of injury or the onset of symptoms in the provided field.
7. Answer whether your injury occurred while playing a sport. If yes, specify the sport.
8. Indicate whether your injury was work-related and, if so, mention your occupation.
9. Rank your primary shoulder problems (pain, weakness, limited motion, instability) by numbering them from 1 to 4 based on severity.
10. Describe how often you have symptoms by circling all applicable options on the form.
11. Answer whether you experience nighttime pain.
12. Provide details of previous treatments, including medications, physical therapy visits, and injections. Be as specific as possible.
13. Share any additional information about your shoulder that could assist your healthcare provider in your assessment.
14. Rate your shoulder condition as a percentage of normal, using the scale from 0 to 100.
15. Complete the section regarding your overall health and activities over the past four weeks, providing honest responses to each question.
16. Review all your entries for accuracy and completeness.
17. Finally, save your changes, download the completed form, and print or share it as necessary.

Complete your Shoulder Assessment Form online today to ensure you receive the appropriate care.