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FUNCTIONAL MOVEMENT SCREEN SCORE SHEET

Raw SCORE : This SCORE is used to denote right and left side scoring. The right and left sides are scored in fiveof the seven tests and both are documented in this SCORE : This SCORE is used to denote the overall SCORE for the test. The lowest SCORE for the raw SCORE (each side) is carried over to give a final SCORE for the test. A person who scores a three on the right and a two on the left would receive a final SCORE of two. The final SCORE is then summarized and used as a total Test: A positive indicates pain. A negative indicates no pain. If pain is present (+),the SCORE for that test would result in a MOVEMENT SCREEN SCORE SHEETADDRESS:SCHOOL/AFFILIATION:HEIGHT:W EIGHT:AGE:GENDER:PRIMARY SPORT:PRIMARY POSITION:HAND/LEG DOMINANCE:TESTDEEP SQUATTOTAL SCREEN SCOREHURDLE STEPINLINE LUNGESHOULDER MOBILITYSHOULDER CLEARING TESTFLEXION CLEARING TESTACTIVE STRAIGHT-LEG RAISETRUNK STABILITY PUSHUPEXTENSION CLEARING TESTROTARY STABILITYLLLLLLRRRRRR+/-+/-+/-+/-RAW SCOREFINAL SCORECOMMENTSPREVIOUS TEST SCORE :NAME:DATE:DOB:CITY, STATE, ZIP:PHONE.

functional movement screen score sheet address: school/affiliation: height: weight: age: gender: primary sport: primary position: hand/leg dominance: test deep squat total screen score hurdle step inline lunge shoulder mobility shoulder clearing test flexion clearing test active straight-leg raise trunk stability pushup extension clearing test ...

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