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OASIS Assessment Tool

Client GoalsSECTION 1 - All Clients to CompletePlease indicate what your goals are by checking the appropriate boxes (check all that apply).To manage my pain1To learn if I need surgery (joint replacement)2To learn how to manage my daily activities at home/work3To improve my ability to be active (specify activities):To manage:Stress / Anxiety / DepressionMedicationSleep disturbancesWeight problemsHealthy Eating4567 Other (specify):To get my home set up for safety and independencePain InventoryRLOn the diagram, shade in all areas where you feel pain.

SECTION 2 Pain Inventory (Continued) Functional Limitations OASIS Assessment Tool - V 18 – October 15, 2013 OASIS Pt ID: Page 2 of 3 3. The following questions are only to be answered if you have osteoarthritis in your hips, feet, ankles,

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