Use our readymade template to create your Patient-Rated Wrist Evaluation (PRWE) form
Create your care assessments
| PRWE score | Proposed treatment |
|---|---|
| 0-20 | May not need treatment |
| 21-40 | Consider physical therapy |
| 41-60 | Consider medication |
| 61-80 | Consider surgery |
| 81-100 | Immediate initiation |
- 15-item questionnaire that scores each item on a scale of 0-10
- Real-time calculation of PRWE Score based on the form responses
- Collect patient data and other sensitive healthcare data using our HIPAA compliant online assessment forms
- 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 |
| At rest | 3 |
| When doing a task with a repeated wrist movement | 4 |
| When lifting a heavy object | 5 |
| When it is at its worst | 6 |
| How often do you have pain? | 7 |
| Turn a door knob using my affected hand | 8 |
| Cut meat using a knife in my affected hand | 9 |
| Fasten buttons on my shirt | 10 |
| Use my affected hand to push up from a chair | 9 |
| Carry a 10lb object in my affected hand | 8 |
| Use bathroom tissue with my affected hand | 7 |
| Personal care activities (dressing, washing) | 6 |
| Household work (cleaning, maintenance) | 5 |
| Work (your job or usual everyday work) | 4 |
| Recreational activities | 3 |
| Pain score | 45 |
| Function score | 30 |
| PRWE score | 75 |
- Send an email invitation with a secure link for patients to complete their PRWE assessment form prior to their visit
- Allow patients to save their progress and complete their PRWE assessment form at a later time without losing any responses
- Set up an email template for your PRWE assessment and automatically send invitation emails to multiple patients with ease
- Send a confirmation email to the patients with their PRWE score, diagnosis, next steps when they submit their PRWE assessment
Track patient responses in Google Sheets
| A | B | C | D | E | |
|---|---|---|---|---|---|
| 1 | Name | Question | Answer | Score | Total Score |
| 2 | John W | At rest | 3 | 3 | 75 |
| 3 | John W | When doing a task with a repeated wrist movement | 4 | 4 | 75 |
| 4 | John W | When lifting a heavy object | 5 | 5 | 75 |
| 5 | John W | When it is at its worst | 6 | 6 | 75 |
| 6 | John W | How often do you have pain? | 7 | 7 | 75 |
| 7 | John W | Turn a door knob using my affected hand | 8 | 8 | 75 |
| 8 | John W | Cut meat using a knife in my affected hand | 9 | 9 | 75 |
| 9 | John W | Fasten buttons on my shirt | 10 | 10 | 75 |
| 10 | John W | Use my affected hand to push up from a chair | 9 | 9 | 75 |
| 11 | John W | Carry a 10lb object in my affected hand | 8 | 8 | 75 |
| 12 | John W | Use bathroom tissue with my affected hand | 7 | 7 | 75 |
| 13 | John W | Personal care activities (dressing, washing) | 6 | 6 | 75 |
| 14 | John W | Household work (cleaning, maintenance) | 5 | 5 | 75 |
| 15 | John W | Work (your job or usual everyday work) | 4 | 4 | 75 |
| 16 | John W | Recreational activities | 3 | 3 | 75 |
- Export patient responses including the calculated PRWE 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 wrist symptoms
- Receive a copy of the response and the calculated PRWE score by email whenever a patient submits their PRWE 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 |
| At rest: | 3 |
| When doing a task with a repeated wrist movement: | 4 |
| When lifting a heavy object: | 5 |
| When it is at its worst: | 6 |
| How often do you have pain? : | 7 |
| Turn a door knob using my affected hand: | 8 |
| Cut meat using a knife in my affected hand: | 9 |
| Fasten buttons on my shirt: | 10 |
| Use my affected hand to push up from a chair: | 9 |
| Carry a 10lb object in my affected hand: | 8 |
| Use bathroom tissue with my affected hand: | 7 |
| Personal care activities (dressing, washing): | 6 |
| Household work (cleaning, maintenance): | 5 |
| Work (your job or usual everyday work): | 4 |
| Recreational activities: | 3 |
| Pain score: | 45 |
| Function score: | 30 |
| PRWE score: | 75 |
| PRWE score: | 75 |
- Create a HIPAA compliant PRWE 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 PRWE form responses to Google Sheets and sending them on email
- Limit access to patient data only for authorized personnel and minimize the risk of data breaches
These reviews are reproduced without modification from Google Workspace Marketplace.
July 27, 2023
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July 23, 2023
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February 16, 2024
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October 31, 2023
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