Patient-Specific Functional Scale

Assesses functional ability by having patients identify and rate activities that are important to them and in which they experience difficulty due to their condition

Instructions:

List up to 5 activities that are important to your daily life and that you find difficult to perform due to your condition. Rate each activity on a scale from 0 (unable to perform) to 10 (able to perform at the same level as before your injury or problem). The average score across your activities will indicate your functional status.

Patient-Specific Functional Scale

Add activities and rate your difficulty

Type: ratings-list

Patient Watch Form - 10/31/2025