Use our readymade template to create your Lower Extremity Functional Scale (LEFS) for assessing patients with lower limb problems
Create your care assessments
LEFS score | Severity |
---|---|
0-20 | Severe |
21-40 | Moderate |
41-60 | Mild |
61-80 | Minimal |
- Prebuilt template with LEFS scoring to assess the presence and severity of lower limb problems
- 20-item questionnaire that scores each item from “0” (Extreme Difficulty or Unable to Perform Activity) to “4” (No Difficulty)
- Real-time calculation of LEFS 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 lower limb problems
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 |
1. Any of usual work, housework or school activities. | A Little Bit of Difficulty |
2. Your usual hobbies, recreational or sporting activities. | Moderate Difficulty |
3. Getting into or out of the bath. | No Difficulty |
4. Walking between rooms. | Quite a Bit of Difficulty |
5. Putting on your shoes or socks. | No Difficulty |
6. Squatting. | A Little Bit of Difficulty |
7. Lifting an object, like a bag of groceries from the floor. | Moderate Difficulty |
8. Performing light activities around your home. | No Difficulty |
9. Performing heaving activities around your home. | Quite a Bit of Difficulty |
10. Getting into or out of a car. | No Difficulty |
11. Walking 2 blocks. | A Little Bit of Difficulty |
12. Walking a mile. | Moderate Difficulty |
13. Going up or down 10 stairs (about 1 flight of stairs). | No Difficulty |
14. Standing for 1 hour. | Quite a Bit of Difficulty |
15. Sitting for 1 hour. | No Difficulty |
16. Running on even ground. | A Little Bit of Difficulty |
17. Running on uneven ground. | Moderate Difficulty |
18. Making sharp turns while running fast. | No Difficulty |
19. Hopping. | A Little Bit of Difficulty |
20. Rolling over in bed. | No Difficulty |
LEFS Score | 60 |
- Pre-populate patient details such as patient id, name, email etc in the LEFS assessment form before sharing it with the patients
- Send an email invitation with a secure link for patients to complete their LEFS assessment form prior to their visit
- Allow patients to save their progress and complete their LEFS assessment form at a later time without losing any responses
- Set up an email template for your LEFS assessment and automatically send invitation emails to multiple patients with ease
- Send a confirmation email to the patients with their LEFS score, diagnosis, next steps when they submit their LEFS assessment
Track patient responses in Google Sheets
A | B | C | D | E | |
---|---|---|---|---|---|
1 | Name | Question | Answer | Score | Total Score |
2 | John W | 1. Any of usual work, housework or school activities. | A Little Bit of Difficulty | 3 | 60 |
3 | John W | 2. Your usual hobbies, recreational or sporting activities. | Moderate Difficulty | 2 | 60 |
4 | John W | 3. Getting into or out of the bath. | No Difficulty | 4 | 60 |
5 | John W | 4. Walking between rooms. | Quite a Bit of Difficulty | 1 | 60 |
6 | John W | 5. Putting on your shoes or socks. | No Difficulty | 4 | 60 |
7 | John W | 6. Squatting. | A Little Bit of Difficulty | 3 | 60 |
8 | John W | 7. Lifting an object, like a bag of groceries from the floor. | Moderate Difficulty | 2 | 60 |
9 | John W | 8. Performing light activities around your home. | No Difficulty | 4 | 60 |
10 | John W | 9. Performing heaving activities around your home. | Quite a Bit of Difficulty | 1 | 60 |
11 | John W | 10. Getting into or out of a car. | No Difficulty | 4 | 60 |
12 | John W | 11. Walking 2 blocks. | A Little Bit of Difficulty | 3 | 60 |
13 | John W | 12. Walking a mile. | Moderate Difficulty | 2 | 60 |
14 | John W | 13. Going up or down 10 stairs (about 1 flight of stairs). | No Difficulty | 4 | 60 |
15 | John W | 14. Standing for 1 hour. | Quite a Bit of Difficulty | 1 | 60 |
16 | John W | 15. Sitting for 1 hour. | No Difficulty | 4 | 60 |
17 | John W | 16. Running on even ground. | A Little Bit of Difficulty | 3 | 60 |
18 | John W | 17. Running on uneven ground. | Moderate Difficulty | 2 | 60 |
19 | John W | 18. Making sharp turns while running fast. | No Difficulty | 4 | 60 |
20 | John W | 19. Hopping. | A Little Bit of Difficulty | 3 | 60 |
21 | John W | 20. Rolling over in bed. | No Difficulty | 4 | 60 |
- Export patient responses including the calculated LEFS score to Google Sheets for easy record-keeping
- Export individual points for 20 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 lower limb problems
- Receive a copy of the response and the calculated LEFS score by email whenever a patient submits their LEFS 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 |
1. Any of usual work, housework or school activities.: | A Little Bit of Difficulty |
2. Your usual hobbies, recreational or sporting activities. : | Moderate Difficulty |
3. Getting into or out of the bath.: | No Difficulty |
4. Walking between rooms.: | Quite a Bit of Difficulty |
5. Putting on your shoes or socks.: | No Difficulty |
6. Squatting.: | A Little Bit of Difficulty |
7. Lifting an object, like a bag of groceries from the floor. : | Moderate Difficulty |
8. Performing light activities around your home.: | No Difficulty |
9. Performing heaving activities around your home.: | Quite a Bit of Difficulty |
10. Getting into or out of a car.: | No Difficulty |
11. Walking 2 blocks.: | A Little Bit of Difficulty |
12. Walking a mile.: | Moderate Difficulty |
13. Going up or down 10 stairs (about 1 flight of stairs).: | No Difficulty |
14. Standing for 1 hour.: | Quite a Bit of Difficulty |
15. Sitting for 1 hour.: | No Difficulty |
16. Running on even ground.: | A Little Bit of Difficulty |
17. Running on uneven ground.: | Moderate Difficulty |
18. Making sharp turns while running fast.: | No Difficulty |
19. Hopping.: | A Little Bit of Difficulty |
20. Rolling over in bed.: | No Difficulty |
LEFS Score: | 60 |
LEFS Score: | 60 |
- Create a HIPAA compliant LEFS 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 LEFS form responses to Google Sheets and sending them on email
- Prepopulate patient details in LEFS 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
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