Use our readymade template to create your Disabilities of the Arm, Shoulder and Hand (DASH) assessment tool
Create your care assessments
DASH score | Severity | Proposed treatment |
---|---|---|
0-20 | Mild | Conservative management |
21-40 | Moderate | Physical therapy |
41-60 | Severe | Surgical intervention |
61-80 | Very severe | Surgical intervention |
81-100 | Extremely severe | Surgical intervention |
- Prebuilt template with DASH scoring to assess the presence of upper limb disorders and measure its severity
- 30-item questionnaire that scores each item based on the patient's ability to perform certain activities and the severity of symptoms
- Real-time calculation of DASH 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 upper limb disorders
- 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 |
1. Open a tight or new jar. | Mild difficulty |
2. Write. | No difficulty |
3. Turn a key. | Moderate difficulty |
4. Prepare a meal. | Severe difficulty |
5. Push open a heavy door. | Unable |
6. Place an object on a shelf above your head. | No difficulty |
7. Do heavy household chores (e.g., wash walls, wash floors). | Mild difficulty |
8. Garden or do yard work. | Moderate difficulty |
9. Make a bed. | Severe difficulty |
10. Carry a shopping bag or briefcase. | Unable |
11. Carry a heavy object (over 10 lbs). | No difficulty |
12. Change a lightbulb overhead. | Mild difficulty |
13. Wash or blow dry your hair. | Moderate difficulty |
14. Wash your back. | Severe difficulty |
15. Put on a pullover sweater. | Unable |
16. Use a knife to cut food. | No difficulty |
17. Recreational activities which require little effort (e.g., card playing, knitting, etc.). | Mild difficulty |
18. Recreational activities in which you take some force or impact through your arm, shoulder or hand (e.g., golf, hammering, tennis, etc.). | Moderate difficulty |
19. Recreational activities in which you move your arm freely (e.g., playing frisbee, badminton, etc.). | Severe difficulty |
20. Manage transportation needs (getting from one place to another). | Unable |
21. Sexual activities. | No difficulty |
22. During the past week, to what extent has your arm, shoulder or hand problem interfered with your normal social activities with family, friends, neighbours or groups? | Slightly |
23. During the past week, were you limited in your work or other regular daily activities as a result of your arm, shoulder or hand problem? | Moderately limited |
24. Arm, shoulder or hand pain. | Severe |
25. Arm, shoulder or hand pain when you performed any specific activity. | Extreme |
26. Tingling (pins and needles) in your arm, shoulder or hand. | None |
27. Weakness in your arm, shoulder or hand. | Mild |
28. Stiffness in your arm, shoulder or hand. | Moderate |
29. During the past week, how much difficulty have you had sleeping because of the pain in your arm, shoulder or hand? | Severe difficulty |
30. I feel less capable, less confident or less useful because of my arm, shoulder or hand problem. | Agree |
DASH score | 45 |
- Pre-populate patient details such as patient id, name, email etc in the DASH assessment form before sharing it with the patients
- Send an email invitation with a secure link for patients to complete their DASH assessment form prior to their visit
- Allow patients to save their progress and complete their DASH assessment form at a later time without losing any responses
- Set up an email template for your DASH assessment and automatically send invitation emails to multiple patients with ease
- Send a confirmation email to the patients with their DASH score, diagnosis, next steps when they submit their DASH assessment
Track patient responses in Google Sheets
A | B | C | D | E | |
---|---|---|---|---|---|
1 | Name | Question | Answer | Score | Total Score |
2 | John W | 1. Open a tight or new jar. | Mild difficulty | 2 | 45 |
3 | John W | 2. Write. | No difficulty | 1 | 45 |
4 | John W | 3. Turn a key. | Moderate difficulty | 3 | 45 |
5 | John W | 4. Prepare a meal. | Severe difficulty | 4 | 45 |
6 | John W | 5. Push open a heavy door. | Unable | 5 | 45 |
7 | John W | 6. Place an object on a shelf above your head. | No difficulty | 1 | 45 |
8 | John W | 7. Do heavy household chores (e.g., wash walls, wash floors). | Mild difficulty | 2 | 45 |
9 | John W | 8. Garden or do yard work. | Moderate difficulty | 3 | 45 |
10 | John W | 9. Make a bed. | Severe difficulty | 4 | 45 |
11 | John W | 10. Carry a shopping bag or briefcase. | Unable | 5 | 45 |
12 | John W | 11. Carry a heavy object (over 10 lbs). | No difficulty | 1 | 45 |
13 | John W | 12. Change a lightbulb overhead. | Mild difficulty | 2 | 45 |
14 | John W | 13. Wash or blow dry your hair. | Moderate difficulty | 3 | 45 |
15 | John W | 14. Wash your back. | Severe difficulty | 4 | 45 |
16 | John W | 15. Put on a pullover sweater. | Unable | 5 | 45 |
17 | John W | 16. Use a knife to cut food. | No difficulty | 1 | 45 |
18 | John W | 17. Recreational activities which require little effort (e.g., card playing, knitting, etc.). | Mild difficulty | 2 | 45 |
19 | John W | 18. Recreational activities in which you take some force or impact through your arm, shoulder or hand (e.g., golf, hammering, tennis, etc.). | Moderate difficulty | 3 | 45 |
20 | John W | 19. Recreational activities in which you move your arm freely (e.g., playing frisbee, badminton, etc.). | Severe difficulty | 4 | 45 |
21 | John W | 20. Manage transportation needs (getting from one place to another). | Unable | 5 | 45 |
22 | John W | 21. Sexual activities. | No difficulty | 1 | 45 |
23 | John W | 22. During the past week, to what extent has your arm, shoulder or hand problem interfered with your normal social activities with family, friends, neighbours or groups? | Slightly | 2 | 45 |
24 | John W | 23. During the past week, were you limited in your work or other regular daily activities as a result of your arm, shoulder or hand problem? | Moderately limited | 3 | 45 |
25 | John W | 24. Arm, shoulder or hand pain. | Severe | 4 | 45 |
26 | John W | 25. Arm, shoulder or hand pain when you performed any specific activity. | Extreme | 5 | 45 |
27 | John W | 26. Tingling (pins and needles) in your arm, shoulder or hand. | None | 1 | 45 |
28 | John W | 27. Weakness in your arm, shoulder or hand. | Mild | 2 | 45 |
29 | John W | 28. Stiffness in your arm, shoulder or hand. | Moderate | 3 | 45 |
30 | John W | 29. During the past week, how much difficulty have you had sleeping because of the pain in your arm, shoulder or hand? | Severe difficulty | 4 | 45 |
31 | John W | 30. I feel less capable, less confident or less useful because of my arm, shoulder or hand problem. | Agree | 4 | 45 |
- Export patient responses including the calculated DASH 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 upper limb function
- Receive a copy of the response and the calculated DASH score by email whenever a patient submits their DASH 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 |
1. Open a tight or new jar.: | Mild difficulty |
2. Write.: | No difficulty |
3. Turn a key.: | Moderate difficulty |
4. Prepare a meal.: | Severe difficulty |
5. Push open a heavy door.: | Unable |
6. Place an object on a shelf above your head.: | No difficulty |
7. Do heavy household chores (e.g., wash walls, wash floors).: | Mild difficulty |
8. Garden or do yard work.: | Moderate difficulty |
9. Make a bed.: | Severe difficulty |
10. Carry a shopping bag or briefcase.: | Unable |
11. Carry a heavy object (over 10 lbs).: | No difficulty |
12. Change a lightbulb overhead.: | Mild difficulty |
13. Wash or blow dry your hair.: | Moderate difficulty |
14. Wash your back.: | Severe difficulty |
15. Put on a pullover sweater.: | Unable |
16. Use a knife to cut food.: | No difficulty |
17. Recreational activities which require little effort (e.g., card playing, knitting, etc.).: | Mild difficulty |
18. Recreational activities in which you take some force or impact through your arm, shoulder or hand (e.g., golf, hammering, tennis, etc.).: | Moderate difficulty |
19. Recreational activities in which you move your arm freely (e.g., playing frisbee, badminton, etc.).: | Severe difficulty |
20. Manage transportation needs (getting from one place to another).: | Unable |
21. Sexual activities.: | No difficulty |
22. During the past week, to what extent has your arm, shoulder or hand problem interfered with your normal social activities with family, friends, neighbours or groups?: | Slightly |
23. During the past week, were you limited in your work or other regular daily activities as a result of your arm, shoulder or hand problem?: | Moderately limited |
24. Arm, shoulder or hand pain.: | Severe |
25. Arm, shoulder or hand pain when you performed any specific activity.: | Extreme |
26. Tingling (pins and needles) in your arm, shoulder or hand.: | None |
27. Weakness in your arm, shoulder or hand.: | Mild |
28. Stiffness in your arm, shoulder or hand.: | Moderate |
29. During the past week, how much difficulty have you had sleeping because of the pain in your arm, shoulder or hand?: | Severe difficulty |
30. I feel less capable, less confident or less useful because of my arm, shoulder or hand problem. : | Agree |
DASH score: | 45 |
DASH score: | 45 |
- Create a HIPAA compliant DASH 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 DASH form responses to Google Sheets and sending them on email
- Prepopulate patient details in DASH 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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