LEFS: Initial Visit
Description: This survey is meant to help us obtain information from our patients regarding their current levels of discomfort and capability. Please select the answers below that best apply.
Name *
Name
0 = No Pain, 10 = Very Severe Pain
(0) Extreme Difficulty or Unable to Perform Activity (1) Quite a Bit of Difficulty (2) Moderate Difficulty (3) A little Bit of Difficulty (4) No Difficulty

Source: Binkley et al (1999): The Lower Extremity Functional Scale (LEFS): Scale development, measurement properties, and clinical application. Physical Therapy. 79:371-383.