Search

Foot and Ankle Disability Index
22 reviews
57K+
Installs

Use our readymade template to create your Foot and Ankle Disability Index (FADI) assessment tool

Create your care assessments

Assessment form builder
  • navigate_next Prebuilt template with FADI scoring to assess the presence and severity of foot and ankle conditions
  • navigate_next 26-item questionnaire that scores each item based on the level of difficulty or pain experienced by the patient
  • navigate_next Real-time calculation of FADI Score based on the form responses
  • navigate_next Collect patient data and other sensitive healthcare data using our HIPAA compliant online assessment forms
  • navigate_next Compare the scores from the initial screening with that of the followup to track the progression of the condition
  • navigate_next 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
  • navigate_next Collect patient details such as patient id, name, email etc in the FADI assessment form
  • navigate_next Send an email invitation with a secure link for patients to complete their FADI assessment form prior to their visit
  • navigate_next Allow patients to save their progress and complete their FADI assessment form at a later time without losing any responses
  • navigate_next Set up an email template for your FADI assessment and automatically send invitation emails to multiple patients with ease
  • navigate_next 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
  • navigate_next Export patient responses including the calculated FADI score to Google Sheets for easy record-keeping
  • navigate_next Export individual points for each item to Google Sheets for data manipulation and analysis for comprehensive insights
  • navigate_next Use pre-built reports to easily keep track of patient progress over time and monitor changes in their foot and ankle conditions
  • navigate_next Receive a copy of the response and the calculated FADI score by email whenever a patient submits their FADI assessment
  • navigate_next 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
  • navigate_next Create a HIPAA compliant FADI assessment form to safely collect, store and access patient responses
  • navigate_next Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI
  • navigate_next Automatically mask PHI fields when exporting FADI form responses to Google Sheets and sending them on email
  • navigate_next Prepopulate patient details in FADI assessments by creating secure prefill links without exposing PHI
  • navigate_next 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 23, 2023

5 stars

I am not tech savvy. I chose formesign to help create registration links for clients. Vipid has been great in assisting me. He goes above and beyond. My company now has moved from the stone age to modern age through the ability to use this feature. Of the many features I am impressed with, the ability to update a form without needing to regenerate a link is amazing. I often make mistakes and that ability allows me to fix mistakes without needing to change everything. Thank you!!!

— Sol Evans

February 16, 2024

1 stars

Does not work

— Myles Sicuro

October 31, 2023

5 stars

We needed a way to create forms with e-signatures and this app made it very easy. Support is also very quick and always helpful. Cannot recommend enough!

— Chris Henesy

July 12, 2023

5 stars

It very friendly to used. I love it. For my case multiple signature needed. it's supporting

— Senthil Kumar

November 27, 2023

5 stars

Yeah this is good for all

— luqman Khan

July 10, 2023

5 stars

We were looking for a way to have a signature option in our form. Formesign addon allowed us to collect signatures for the acknowledgment and consent forms. It was simple and easy to setup. Very useful addon for google forms.

— Joan S

More...

Tags

Foot Ankle Care assessments
close