Use our readymade template to create your Foot and Ankle Disability Index (FADI) assessment tool
Create your care assessments
- Prebuilt template with FADI scoring to assess the presence and severity of foot and ankle conditions
- 26-item questionnaire that scores each item based on the level of difficulty or pain experienced by the patient
- Real-time calculation of FADI Score based on the form responses
- Collect patient data and other sensitive healthcare data using our HIPAA compliant online assessment forms
- Compare the scores from the initial screening with that of the followup to track the progression of the condition
- Easily create responsive forms that allow patients to complete their assessments on any device at any time
Collect responses from your patients
| Patient ID | 1004 |
| Patient Name | John W |
| Patient Email | johnw@ymail.com |
| Patient Phone Number | 0987654321 |
| Doctor's Name | Dr. Smith |
| Location | New York |
| Select the difficult level for each activity | |
| 1. Standing | None at all |
| 2. Walking on even ground | Slight |
| 3. Walking on even ground without shoes | Moderate |
| 4. Walking up hills | Extreme |
| 5. Walking down hills | Unable |
| 6. Going up stairs | None at all |
| 7. Going down stairs | Slight |
| 8. Walking on uneven ground | Moderate |
| 9. Stepping up and down curves | Extreme |
| 10. Squatting | Unable |
| 11. Sleeping | None at all |
| 12. Coming up to your toes | Slight |
| 13. Walking initially | Moderate |
| 14. Walking 5 minutes or less | Extreme |
| 15. Walking approximately 10 minutes | Unable |
| 16. Walking 15 minutes or greater | None at all |
| 17. Home responsibilities | Slight |
| 18. Activities of daily living | Moderate |
| 19. Personal care | Extreme |
| 20. Light to moderate work (standing, walking) | Unable |
| 21. Heavy work (push/pulling, climbing, carrying) | None at all |
| 22. Recreational activities | Slight |
| Select the level of pain | |
| 23. General level of pain | Moderate |
| 24. Pain at rest | Extreme |
| 25. Pain during your normal activity | Unable |
| 26. Pain first thing in the morning | None at all |
| FADI Score (in %) | 75 |
- Collect patient details such as patient id, name, email etc in the FADI assessment form
- Send an email invitation with a secure link for patients to complete their FADI assessment form prior to their visit
- Allow patients to save their progress and complete their FADI assessment form at a later time without losing any responses
- Set up an email template for your FADI assessment and automatically send invitation emails to multiple patients with ease
- Send a confirmation email to the patients with their FADI score, diagnosis, next steps when they submit their FADI assessment
Track patient responses in Google Sheets
| A | B | C | D | E | |
|---|---|---|---|---|---|
| 1 | Name | Question | Answer | Score | Total Score |
| 2 | John W | 1. Standing | None at all | 4 | 75 |
| 3 | John W | 2. Walking on even ground | Slight | 3 | 75 |
| 4 | John W | 3. Walking on even ground without shoes | Moderate | 2 | 75 |
| 5 | John W | 4. Walking up hills | Extreme | 1 | 75 |
| 6 | John W | 5. Walking down hills | Unable | 0 | 75 |
| 7 | John W | 6. Going up stairs | None at all | 4 | 75 |
| 8 | John W | 7. Going down stairs | Slight | 3 | 75 |
| 9 | John W | 8. Walking on uneven ground | Moderate | 2 | 75 |
| 10 | John W | 9. Stepping up and down curves | Extreme | 1 | 75 |
| 11 | John W | 10. Squatting | Unable | 0 | 75 |
| 12 | John W | 11. Sleeping | None at all | 4 | 75 |
| 13 | John W | 12. Coming up to your toes | Slight | 3 | 75 |
| 14 | John W | 13. Walking initially | Moderate | 2 | 75 |
| 15 | John W | 14. Walking 5 minutes or less | Extreme | 1 | 75 |
| 16 | John W | 15. Walking approximately 10 minutes | Unable | 0 | 75 |
| 17 | John W | 16. Walking 15 minutes or greater | None at all | 4 | 75 |
| 18 | John W | 17. Home responsibilities | Slight | 3 | 75 |
| 19 | John W | 18. Activities of daily living | Moderate | 2 | 75 |
| 20 | John W | 19. Personal care | Extreme | 1 | 75 |
| 21 | John W | 20. Light to moderate work (standing, walking) | Unable | 0 | 75 |
| 22 | John W | 21. Heavy work (push/pulling, climbing, carrying) | None at all | 4 | 75 |
| 23 | John W | 22. Recreational activities | Slight | 3 | 75 |
| 24 | John W | 23. General level of pain | Moderate | 2 | 75 |
| 25 | John W | 24. Pain at rest | Extreme | 75 | |
| 26 | John W | 25. Pain during your normal activity | Unable | 75 | |
| 27 | John W | 26. Pain first thing in the morning | None at all | 75 |
- Export patient responses including the calculated FADI score to Google Sheets for easy record-keeping
- Export individual points for each item to Google Sheets for data manipulation and analysis for comprehensive insights
- Use pre-built reports to easily keep track of patient progress over time and monitor changes in their foot and ankle conditions
- Receive a copy of the response and the calculated FADI score by email whenever a patient submits their FADI assessment
- Use data in Google Sheets to integrate with external EHR systems for seamless data transfer
HIPAA compliance
| Patient ID: | 1004 |
| Patient Name: | ****** |
| Patient Email: | ****** |
| Patient Phone Number: | ****** |
| Doctor's Name: | Dr. Smith |
| Location: | New York |
| Select the difficult level for each activity | |
| 1. Standing: | None at all |
| 2. Walking on even ground: | Slight |
| 3. Walking on even ground without shoes: | Moderate |
| 4. Walking up hills: | Extreme |
| 5. Walking down hills: | Unable |
| 6. Going up stairs: | None at all |
| 7. Going down stairs: | Slight |
| 8. Walking on uneven ground: | Moderate |
| 9. Stepping up and down curves: | Extreme |
| 10. Squatting: | Unable |
| 11. Sleeping: | None at all |
| 12. Coming up to your toes: | Slight |
| 13. Walking initially: | Moderate |
| 14. Walking 5 minutes or less: | Extreme |
| 15. Walking approximately 10 minutes: | Unable |
| 16. Walking 15 minutes or greater: | None at all |
| 17. Home responsibilities: | Slight |
| 18. Activities of daily living: | Moderate |
| 19. Personal care: | Extreme |
| 20. Light to moderate work (standing, walking): | Unable |
| 21. Heavy work (push/pulling, climbing, carrying): | None at all |
| 22. Recreational activities: | Slight |
| Select the level of pain | |
| 23. General level of pain: | Moderate |
| 24. Pain at rest: | Extreme |
| 25. Pain during your normal activity: | Unable |
| 26. Pain first thing in the morning: | None at all |
| FADI Score (in %): | 75 |
| FADI Score (in %): | 75 |
- Create a HIPAA compliant FADI assessment form to safely collect, store and access patient responses
- Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI
- Automatically mask PHI fields when exporting FADI form responses to Google Sheets and sending them on email
- Prepopulate patient details in FADI assessments by creating secure prefill links without exposing PHI
- Limit access to patient data only for authorized personnel and minimize the risk of data breaches
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