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Foot and Ankle Ability Measure (FAAM)
Heavy work (push/pulling, climbing, carrying) 4 3 2 1 0 Recreational activities 4 3 2 1 0 How would you rate your current level of function during you usual activities of daily living from 0 to 100 with 100 being your level of function prior to your foot or ankle problem and 0 being the inability to perform any of your usual daily activities. ...
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Patient Name: Date: TMD Disability Index Questionnaire
smcnd.orgSection 10 - Dizziness (Lightheaded, Spinning and/or Balance Disturbance) I do not experience dizziness. I experience dizziness, but it does not interfere with my daily activities. I experience dizziness which interferes somewhat with my daily activities, but I can accomplish my set goals.
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