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Flushing, NY
Flushing, NY
Welcome to our Flushing, NY location.
Oswestry Disability Index Calculator
First Name
Last Name
Current Date
Question 1: Pain Intensity
*
I have no pain at the moment
The pain is very mild at the moment
The pain is moderate at the moment
The pain is fairly severe at the moment
The pain is very severe at the moment
The pain is the worst imaginable at the moment
Question 6: Standing
*
I can stand as long as I want without extra pain
I can stand as long as I want but it gives me extra pain
Pain prevents me from standing for more than 1 hour
Pain prevents me from standing for more than 30 minutes
Pain prevents me from standing for more than 10 minutes
Pain prevents me from standing at all
Question 2: Personal Care (Washing, Dressing, etc.)
*
I can look after myself normally without causing extra pain
I can look after myself normally but it causes extra pain
It is painful to look after myself and I am slow and careful
I need some help but can manage most of my personal care
I need help every day in most aspects of self-care
I do not get dressed, I wash with difficulty and stay in bed
Question 7: Sleeping
*
My sleep is never disturbed by pain
My sleep is occasionally disturbed by pain
Because of pain, I have less than 6 hours sleep
Because of pain, I have less than 4 hours sleep
Because of pain, I have less than 2 hours sleep
Pain prevents me from sleeping at all
Question 3: Lifting
*
I can lift heavy weights without extra pain
I can lift heavy weights but it gives extra pain
Pain prevents me lifting heavy weights off the floor, but I can manage if they are conveniently placed
Pain prevents me from lifting heavy weights but I can manage light to medium weights if they are conveniently positioned
I can only lift very light weights
I cannot lift or carry anything
Question 8: Sex Life (if applicable)
*
My sex life is normal and causes no extra pain
My sex life is normal but causes some extra pain
My sex life is nearly normal but is very painful
My sex life is severely restricted by pain
My sex life is nearly absent because of pain
Pain prevents any sex life at all
Question 4: Walking
*
Pain does not prevent me walking any distance
Pain prevents me from walking more than 1 mile
Pain prevents me from walking more than ½ mile
Pain prevents me from walking more than 100 yards
I can only walk using a stick or crutches
I am in bed most of the time
Question 9: Social Life
*
My social life is normal and gives me no extra pain
My social life is normal but increases the degree of pain
Pain has no significant effect on my social life apart from limiting my more energetic interests, for example, sport
Pain has restricted my social life and I do not go out as often
Pain has restricted my social life to my home
I have no social life because of pain
Question 5: Sitting
*
I can sit in any chair as long as I like
I can only sit in my favorite chair as long as I like
Pain prevents me from sitting more than 1 hour
Pain prevents me from sitting more than 30 minutes
Pain prevents me from sitting more than 10 minutes
Pain prevents me from sitting at all
Question 10: Traveling
*
I can travel anywhere without pain
I can travel anywhere but it gives me extra pain
Pain is bad but I manage journeys over two hours
Pain restricts me to journeys of less than 1 hour
Pain restricts me to short necessary journeys under 30 minutes
Pain prevents me from traveling except to receive treatment
Total Score
Oswestry Score
%
Submit
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KOOS-12 for Knee
First Name
Last Name
Current Date
Please rate your ability to do the following activities in the last week:
Question 1: How often do you experience knee pain?
*
Never
Monthly
Weekly
Daily
Always
Question 7: Getting in/out of car
*
None
Mild
Moderate
Severe
Extreme
Question 2: What amount of knee pain have you experienced the last week during the following activities; Walking on a flat surface?
*
None
Mild
Moderate
Severe
Extreme
Question 8: Twisting/pivoting on your injured knee
*
None
Mild
Moderate
Severe
Extreme
Question 3: Going up or down stairs
*
None
Mild
Moderate
Severe
Extreme
Question 9: How often are you aware of your knee problem?
*
Never
Monthly
Weekly
Daily
Constantly
Question 4: Sitting or lying
*
None
Mild
Moderate
Severe
Extreme
Question 10: Have you modified your life style to avoid activities potentially damaging to your knee?
*
Not at all
Mildly
Moderately
Severely
Totally
Question 5: Rising from sitting
*
None
Mild
Moderate
Severe
Extreme
Question 11: How much are you troubled with lack of confidence in your knee?
*
Not at all
Mildly
Moderately
Severely
Extremely
Question 6: Standing
*
None
Mild
Moderate
Severe
Extreme
Question 12: In general, how much difficulty do you have with your knee?
*
None
Mild
Moderate
Severe
Extreme
KOOS-12 Score
Submit
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HOOS-12 Score
First Name
Last Name
Current Date
Please rate your ability to do the following activities in the last week:
Question 1: How often do you experience hip pain?
*
Never
Monthly
Weekly
Daily
Always
Question 7: Getting in/out of car
*
None
Mild
Moderate
Severe
Extreme
Question 2: What amount of hip pain have you experienced the last week during the following activities; Walking on a flat surface?
*
None
Mild
Moderate
Severe
Extreme
Question 8: Walking on an uneven surface
*
None
Mild
Moderate
Severe
Extreme
Question 3: Going up or down stairs
*
None
Mild
Moderate
Severe
Extreme
Question 9: How often are you aware of your hip problem?
*
Never
Monthly
Weekly
Daily
Constantly
Question 4: Sitting or lying
*
None
Mild
Moderate
Severe
Extreme
Question 10: Have you modified your life style to avoid activities potentially damaging to your hip?
*
Not at all
Mildly
Moderately
Severely
Totally
Question 5: Rising from sitting
*
None
Mild
Moderate
Severe
Extreme
Question 11: How much are you troubled with lack of confidence in your hip?
*
Not at all
Mildly
Moderately
Severely
Extremely
Question 6: Standing
*
None
Mild
Moderate
Severe
Extreme
Question 12: In general, how much difficulty do you have with your hip?
*
None
Mild
Moderate
Severe
Extreme
HOOS-12 Score
Submit
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Quick DASH Score Calculator
First Name
Last Name
Current Date
Please rate your ability to do the following activities in the last week:
Question 1: Open a tight or new jar
*
No Difficulty
Mild Difficulty
Moderate Difficulty
Severe Difficulty
Unable
Question 6: Recreational activities in which you take some force or impact through your arm, shoulder, or hand (e.g., golf, hammering, tennis, etc.).
*
No Difficulty
Mild Difficulty
Moderate Difficulty
Severe Difficulty
Unable
Question 2: Do heavy household chores (e.g., wash walls, floors, etc.).
*
No Difficulty
Mild Difficulty
Moderate Difficulty
Severe Difficulty
Unable
Question 7: During the past week, to what extent has your arm, shoulder, or hand problem interfered with your normal social activities with family, friends, neighbors, or groups?
*
No Difficulty
Mild Difficulty
Moderate Difficulty
Severe Difficulty
Unable
Question 3: Carry a shopping bag or briefcase.
*
No Difficulty
Mild Difficulty
Moderate Difficulty
Severe Difficulty
Unable
Question 8: 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?
*
No Difficulty
Mild Difficulty
Moderate Difficulty
Severe Difficulty
Unable
Question 4: Wash your back.
*
No Difficulty
Mild Difficulty
Moderate Difficulty
Severe Difficulty
Unable
Question 9: In the last week, please rate the severity of arm, shoulder, or hand pain.
*
No Difficulty
Mild Difficulty
Moderate Difficulty
Severe Difficulty
Unable
Question 5: Use a knife to cut food.
*
No Difficulty
Mild Difficulty
Moderate Difficulty
Severe Difficulty
Unable
Question 10: In the last week, please rate the severity of tingling (pins and needles) in your arm, shoulder, or hand.
*
No Difficulty
Mild Difficulty
Moderate Difficulty
Severe Difficulty
Unable
Question 11: During the past week, how much difficulty have you had sleeping because of the pain in your arm, shoulder, or hand?
*
No Difficulty
Mild Difficulty
Moderate Difficulty
Severe Difficulty
Unable
Total Score
Quick DASH Score
Submit
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Lower Extremity Functional Scale
First Name
Last Name
Current Date
Question 1: Any of your usual work, housework, or school activities
*
No difficulty
A little bit of difficulty
Moderate difficulty
Quite a bit of difficulty
Extreme difficulty or unable to perform activity
Question 11: Walking 2 blocks.
*
No difficulty
A little bit of difficulty
Moderate difficulty
Quite a bit of difficulty
Extreme difficulty or unable to perform activity
Question 2: Your usual hobbies, recreational, or sporting activities.
*
No difficulty
A little bit of difficulty
Moderate difficulty
Quite a bit of difficulty
Extreme difficulty or unable to perform activity
Question 12: Walking a mile.
*
No difficulty
A little bit of difficulty
Moderate difficulty
Quite a bit of difficulty
Extreme difficulty or unable to perform activity
Question 3: Getting into or out of the bath.
*
No difficulty
A little bit of difficulty
Moderate difficulty
Quite a bit of difficulty
Extreme difficulty or unable to perform activity
Question 13: Going up or down 10 stairs (about 1 flight of stairs).
*
No difficulty
A little bit of difficulty
Moderate difficulty
Quite a bit of difficulty
Extreme difficulty or unable to perform activity
Question 4: Walking between rooms.
*
No difficulty
A little bit of difficulty
Moderate difficulty
Quite a bit of difficulty
Extreme difficulty or unable to perform activity
Question 14: Standing for 1 hour.
*
No difficulty
A little bit of difficulty
Moderate difficulty
Quite a bit of difficulty
Extreme difficulty or unable to perform activity
Question 5: Putting on your shoes or socks.
*
No difficulty
A little bit of difficulty
Moderate difficulty
Quite a bit of difficulty
Extreme difficulty or unable to perform activity
Question 15: Sitting for 1 hour.
*
No difficulty
A little bit of difficulty
Moderate difficulty
Quite a bit of difficulty
Extreme difficulty or unable to perform activity
Question 6: Squatting
*
No difficulty
A little bit of difficulty
Moderate difficulty
Quite a bit of difficulty
Extreme difficulty or unable to perform activity
Question 16: Running on even ground.
*
No difficulty
A little bit of difficulty
Moderate difficulty
Quite a bit of difficulty
Extreme difficulty or unable to perform activity
Question 7: Lifting an object, like a bag of groceries from the floor.
*
No difficulty
A little bit of difficulty
Moderate difficulty
Quite a bit of difficulty
Extreme difficulty or unable to perform activity
Question 17: Running on uneven ground.
*
No difficulty
A little bit of difficulty
Moderate difficulty
Quite a bit of difficulty
Extreme difficulty or unable to perform activity
Question 8: Performing light activities around your home.
*
No difficulty
A little bit of difficulty
Moderate difficulty
Quite a bit of difficulty
Extreme difficulty or unable to perform activity
Question 18: Making sharp turns while running fast.
*
No difficulty
A little bit of difficulty
Moderate difficulty
Quite a bit of difficulty
Extreme difficulty or unable to perform activity
Question 9: Performing heavy activities around your home.
*
No difficulty
A little bit of difficulty
Moderate difficulty
Quite a bit of difficulty
Extreme difficulty or unable to perform activity
Question 19: Hopping.
*
No difficulty
A little bit of difficulty
Moderate difficulty
Quite a bit of difficulty
Extreme difficulty or unable to perform activity
Question 10: Getting into or out of a car.
*
No difficulty
A little bit of difficulty
Moderate difficulty
Quite a bit of difficulty
Extreme difficulty or unable to perform activity
Question 20: Rolling over in bed.
*
No difficulty
A little bit of difficulty
Moderate difficulty
Quite a bit of difficulty
Extreme difficulty or unable to perform activity
Total Score
Lower Extremity Functional Score
%
Submit
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Neck Disability Index (NDI) Calculator
First Name
Last Name
Current Date
Question 1: Pain Intensity
*
I have no pain at the moment
The pain is very mild at the moment
The pain is moderate at the moment
The pain is fairly severe at the moment
The pain is very severe at the moment
The pain is the worst imaginable at the moment
Question 6: Concentration
*
I can concentrate fully when I want to with no difficulty
I can concentrate fully when I want to with slight difficulty
I have a fair degree of difficulty in concentrating when I want to
I have a lot of difficulty in concentrating when I want to
I have a great deal of difficulty in concentrating when I want to
I cannot concentrate at all
Question 2: Personal Care (Washing, Dressing, etc.)
*
I can look after myself normally without causing extra pain
I can look after myself normally but it causes extra pain
It is painful to look after myself and I am slow and careful
I need some help but can manage most of my personal care
I need help every day in most aspects of self-care
I do not get dressed, I wash with difficulty and stay in bed
Question 7: Work
*
I can do as much work as I want to
I can only do my usual work, but no more
I can do most of my usual work, but no more
I can’t do my usual work
I can hardly do any work at all
I can’t do any work at all
Question 3: Lifting
*
I can lift heavy weights without extra pain
I can lift heavy weights but it gives extra pain
Pain prevents me lifting heavy weights off the floor, but I can manage if they are conveniently placed
Pain prevents me from lifting heavy weights but I can manage light to medium weights if they are conveniently positioned
I can only lift very light weights
I cannot lift or carry anything
Question 8: Driving
*
I can drive my car without any neck pain
I can drive my car as long as I want with slight pain in my neck
I can drive my car as long as I want with moderate pain in my neck
I can’t drive my car as long as I want because of moderate pain in my neck
I can hardly drive at all because of severe pain in my neck
I can’t drive my car at all
Question 4: Reading
*
I can read as much as I want to with no pain in my neck
I can read as much as I want to with slight pain in my neck
I can read as much as I want with moderate pain in my neck
I can’t read as much as I want because of moderate pain in my neck
I can hardly read at all because of severe pain in my neck
I cannot read at all
Question 9: Sleeping
*
I have no trouble sleeping
My sleep is slightly disturbed (less than 1 hr sleepless)
My sleep is mildly disturbed (1-2 hours sleepless)
My sleep is moderately disturbed (2-3 hours sleepless)
My sleep is greatly disturbed (3-5 hours sleepless)
My sleep is completely disturbed (5-7 hours sleepless)
Question 5: Headaches
*
I have no headaches at all
I have slight headaches, which come infrequently
I have moderate headaches, which come infrequently
I have moderate headaches, which come frequently
I have severe headaches, which come frequently
I have headaches almost all the time
Question 10: Recreation
*
I am able to engage in all my recreation activities with no neck pain at all
I am able to engage in all my recreation activities, with some pain in my neck
I am able to engage in most, but not all of my usual recreation activities because of pain in my neck
I am able to engage in a few of my usual recreation activities because of pain in my neck
I can hardly do any recreation activities because of pain in my neck
I can’t do any recreation activities at all
Total Score
Neck Disability Index Score
%
Submit
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*
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*
Phone Number
Street Address
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Please provide your insurance information. So we can verify your eligibility for these services.
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