Work Function Assessment Form Survey

The Work Function Assessment Form is provided to help you determine a patient’s capacity to function effectively at his or her job. Please evaluate the usefulness of the form by filling out this survey.

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* 1. This form contains the right questions to help determine an individual's work function capacity.

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* 2. I will use this form as a regular practice in my professional setting.

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* 3. The impairment scale contains all the components needed to move beyond a person's diagnostic condition to work functionality.

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* 4. My overall experience using the Work Function Assessment Form was positive.

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* 5. This form helped me more accurately determine Activities of Daily Living.

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* 6. This form helped me more accurately determine Social Functioning.

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* 7. This form helped me more accurately determine Concentration, Persistence and Pace.

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* 8. This form helped me more accurately determine Performance of Mental-Interpersonal, Time-Management and Physical Tasks.

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* 9. In the last three months, how often have you used this form?

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* 10. I prefer this form over any other disability form.

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