Use our readymade template to create your Foot Function Index (FFI) assessment tool for foot pain
Create your care assessments
FFI Score | FFI Score (in %) | Proposed treatment |
---|---|---|
0-34 | 0-20% | May not need treatment |
35-68 | 21-40% | Consider physical therapy |
69-102 | 41-60% | Consider medication |
103-136 | 61-80% | Consider surgery |
137-170 | 81-100% | Immediate initiation |
- Prebuilt template with FFI scoring to assess the presence of foot pain and measure its severity
- 23-item questionnaire that scores each item on a scale from 0 to 10
- Real-time calculation of FFI Score and FFI Score (in %) 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 foot pain
- Easily create responsive forms that allow patients to complete their assessments on any device at any time
Collect responses from your patients
Patient Name | John W |
Patient Email | johnw@ymail.com |
Patient Phone Number | 0987654321 |
Doctor's Name | Dr. Smith |
Location | New York |
1. In the morning upon taking your first step? | 5 |
2. When walking? | 6 |
3. When standing? | 4 |
4. How is your pain at the end of the day? | 7 |
5. How severe is your pain at its worst? | 8 |
6. When walking in the house? | 3 |
7. When walking outside? | 2 |
8. When walking four blocks? | 1 |
9. When climbing stairs? | 2 |
10. When descending stairs? | 3 |
11. When standing tip toe? | 4 |
12. When getting up from a chair? | 5 |
13. When climbing curbs? | 6 |
14. When running or fast walking? | 7 |
15. Use an assistive device (cane, walker, crutches, etc) indoors? | 8 |
16. Use an assistive device (cane, walker, crutches, etc) outdoors? | 9 |
17. Limit physical activities? | 10 |
FFI Score | 85 |
FFI Score (in %) | 50 |
- Pre-populate patient details such as patient id, name, email etc in the FFI assessment form before sharing it with the patients
- Send an email invitation with a secure link for patients to complete their FFI assessment form prior to their visit
- Allow patients to save their progress and complete their FFI assessment form at a later time without losing any responses
- Set up an email template for your FFI assessment and automatically send invitation emails to multiple patients with ease
- Send a confirmation email to the patients with their FFI score, diagnosis, next steps when they submit their FFI assessment
Track patient responses in Google Sheets
A | B | C | D | E | |
---|---|---|---|---|---|
1 | Name | Question | Answer | Score | Total Score |
2 | John W | 1. In the morning upon taking your first step? | 5 | 5 | 85 |
3 | John W | 2. When walking? | 6 | 6 | 85 |
4 | John W | 3. When standing? | 4 | 4 | 85 |
5 | John W | 4. How is your pain at the end of the day? | 7 | 7 | 85 |
6 | John W | 5. How severe is your pain at its worst? | 8 | 8 | 85 |
7 | John W | 6. When walking in the house? | 3 | 3 | 85 |
8 | John W | 7. When walking outside? | 2 | 2 | 85 |
9 | John W | 8. When walking four blocks? | 1 | 1 | 85 |
10 | John W | 9. When climbing stairs? | 2 | 2 | 85 |
11 | John W | 10. When descending stairs? | 3 | 3 | 85 |
12 | John W | 11. When standing tip toe? | 4 | 4 | 85 |
13 | John W | 12. When getting up from a chair? | 5 | 5 | 85 |
14 | John W | 13. When climbing curbs? | 6 | 6 | 85 |
15 | John W | 14. When running or fast walking? | 7 | 7 | 85 |
16 | John W | 15. Use an assistive device (cane, walker, crutches, etc) indoors? | 8 | 8 | 85 |
17 | John W | 16. Use an assistive device (cane, walker, crutches, etc) outdoors? | 9 | 9 | 85 |
18 | John W | 17. Limit physical activities? | 10 | 10 | 85 |
- Export patient responses including the calculated FFI score and FFI score (in %) 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 pain symptoms
- Receive a copy of the response and the calculated FFI score by email whenever a patient submits their FFI assessment
- Use data in Google Sheets to integrate with external EHR systems for seamless data transfer
HIPAA compliance
Patient Name: | ****** |
Patient Email: | ****** |
Patient Phone Number: | ****** |
Doctor's Name: | Dr. Smith |
Location: | New York |
1. In the morning upon taking your first step?: | 5 |
2. When walking?: | 6 |
3. When standing? : | 4 |
4. How is your pain at the end of the day? : | 7 |
5. How severe is your pain at its worst?: | 8 |
6. When walking in the house?: | 3 |
7. When walking outside? : | 2 |
8. When walking four blocks? : | 1 |
9. When climbing stairs?: | 2 |
10. When descending stairs?: | 3 |
11. When standing tip toe?: | 4 |
12. When getting up from a chair?: | 5 |
13. When climbing curbs?: | 6 |
14. When running or fast walking?: | 7 |
15. Use an assistive device (cane, walker, crutches, etc) indoors?: | 8 |
16. Use an assistive device (cane, walker, crutches, etc) outdoors?: | 9 |
17. Limit physical activities?: | 10 |
FFI Score: | 85 |
FFI Score (in %): | 50 |
FFI Score: | 85 |
- Create a HIPAA compliant FFI 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 FFI form responses to Google Sheets and sending them on email
- Prepopulate patient details in FFI 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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