Use our readymade template to create your Foot and Ankle Ability Measure (FAAM) assessment tool
Create your care assessments
| FAAM score | Severity | Proposed treatment |
|---|---|---|
| 80-100% | Minimal | May not need treatment |
| 60-79% | Mild | Physical therapy |
| 40-59% | Moderate | Consider surgery |
| 20-39% | Severe | Surgery |
| 0-19% | Very severe | Immediate initiation |
- Prebuilt template with FAAM scoring to assess the presence of foot and ankle disorders and measure their severity
- 21-item questionnaire that scores each item from “0” (Unable) to “4” (None at all)
- Real-time calculation of FAAM 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 the disorder
- 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. Coming up to your toes | None at all |
| 12. Walking initially | Slight |
| 13. Walking 5 minutes or less | Moderate |
| 14. Walking approximately 10 minutes | Extreme |
| 15. Walking 15 minutes or greater | Unable |
| 16. Home responsibilities | None at all |
| 17. Activities of daily living | Slight |
| 18. Personal care | Moderate |
| 19. Light to moderate work (standing, walking) | Extreme |
| 20. Heavy work (push/pulling, climbing, carrying) | Unable |
| 21. Recreational activities | None at all |
| FAAM Score (in %) | 60 |
- Pre-populate patient details such as patient id, name, email etc in the FAAM assessment form before sharing it with the patients
- Send an email invitation with a secure link for patients to complete their FAAM assessment form prior to their visit
- Allow patients to save their progress and complete their FAAM assessment form at a later time without losing any responses
- Set up an email template for your FAAM assessment and automatically send invitation emails to multiple patients with ease
- Send a confirmation email to the patients with their FAAM score, diagnosis, next steps when they submit their FAAM 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 | 60 |
| 3 | John W | 2. Walking on even ground | Slight | 3 | 60 |
| 4 | John W | 3. Walking on even ground without shoes | Moderate | 2 | 60 |
| 5 | John W | 4. Walking up hills | Extreme | 1 | 60 |
| 6 | John W | 5. Walking down hills | Unable | 0 | 60 |
| 7 | John W | 6. Going up stairs | None at all | 4 | 60 |
| 8 | John W | 7. Going down stairs | Slight | 3 | 60 |
| 9 | John W | 8. Walking on uneven ground | Moderate | 2 | 60 |
| 10 | John W | 9. Stepping up and down curves | Extreme | 1 | 60 |
| 11 | John W | 10. Squatting | Unable | 0 | 60 |
| 12 | John W | 11. Coming up to your toes | None at all | 4 | 60 |
| 13 | John W | 12. Walking initially | Slight | 3 | 60 |
| 14 | John W | 13. Walking 5 minutes or less | Moderate | 2 | 60 |
| 15 | John W | 14. Walking approximately 10 minutes | Extreme | 1 | 60 |
| 16 | John W | 15. Walking 15 minutes or greater | Unable | 0 | 60 |
| 17 | John W | 16. Home responsibilities | None at all | 4 | 60 |
| 18 | John W | 17. Activities of daily living | Slight | 3 | 60 |
| 19 | John W | 18. Personal care | Moderate | 2 | 60 |
| 20 | John W | 19. Light to moderate work (standing, walking) | Extreme | 1 | 60 |
| 21 | John W | 20. Heavy work (push/pulling, climbing, carrying) | Unable | 0 | 60 |
| 22 | John W | 21. Recreational activities | None at all | 4 | 60 |
- Export patient responses including the calculated FAAM score to Google Sheets for easy record-keeping
- Export individual points for 21 items 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 foot and ankle disorders
- Receive a copy of the response and the calculated FAAM score by email whenever a patient submits their FAAM 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 |
| 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. Coming up to your toes: | None at all |
| 12. Walking initially: | Slight |
| 13. Walking 5 minutes or less: | Moderate |
| 14. Walking approximately 10 minutes: | Extreme |
| 15. Walking 15 minutes or greater: | Unable |
| 16. Home responsibilities: | None at all |
| 17. Activities of daily living: | Slight |
| 18. Personal care: | Moderate |
| 19. Light to moderate work (standing, walking): | Extreme |
| 20. Heavy work (push/pulling, climbing, carrying): | Unable |
| 21. Recreational activities: | None at all |
| FAAM Score (in %): | 60 |
| FAAM Score (in %): | 60 |
- Create a HIPAA compliant FAAM 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 FAAM form responses to Google Sheets and sending them on email
- Prepopulate patient details in FAAM 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
These reviews are reproduced without modification from Google Workspace Marketplace.
July 23, 2023
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
October 31, 2023
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
February 16, 2024
Does not work
— Myles Sicuro
July 12, 2023
It very friendly to used. I love it. For my case multiple signature needed. it's supporting
— Senthil Kumar
November 27, 2023
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July 10, 2023
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