What questionnaire and outcome measure templates are available?

Embodia includes a library of questionnaires, outcome measures, intake forms, and consent form templates you can use to quickly build standardized forms for your patients. These templates can be customized — including editing questions and duplicating questions — to match your practice needs.

This guide will help you understand which templates are available and how they are organized. If you need help creating a questionnaire from one of these templates, see creating questionnaires from a template.

Please note that new templates may be added over time, so it’s best to check your account directly if you are an Embodia Tier 2 or Tier 3 Member.

Outcome Measures:

• Berg Balance Tests and Rating Scale
• Brain Injury Vision Symptom Survey (BVISS)
• Depression Anxiety Stress Scales (DASS 21)
• Dizziness Handicap Inventory
• Edinburgh Postnatal Depression Scale
• Fatigue Severity Scale
• Fear-Avoidance Beliefs Questionnaire (FABQ)
• Headache Disability Index
• Index de l’incapacité reliée à la douleur
• Insomnia Severity Index
• Knee Injury and Osteoarthritis Outcome Score (KOOS)
• Lower Extremity Functional Scale (LEFS)
• Neck Disability Index (NDI)
• Pain Catastrophizing Scale (PCS)
• Pain Disability Index
• Pain Self-Efficacy Questionnaire (PSEQ)
• Patient Rated Wrist/Hand Evaluation (PRWHE)
• Pelvic Health Patient History Intake Form Intake form
• Pelvic Health Screening (PHS)
• Post-Concussion Symptom Scale
• Shoulder Pain and Disability Index (SPADI)
• Tampa Scale for Kinesiophobia
• TELUS eClaims - Electronic transmission authorization and consent form Consent form
• The Central Sensitization Inventory (CSI)
• The Rivermead Post-Concussion Symptoms Questionnaire
• The Roland-Morris Disability Questionnaire
• Upper Extremity Functional Scale (UEFS) 
• Vulvar Pain Functional Questionnaire (V-Q)

Intake and consent forms:

• COVID-19 Screening
• Intake Form - General
• Intake Form - Personal information 
• Intake Form - Vestibular
• Consent Form - General 
• Pelvic Health Symptom Monitor
• Net Promoter Score (NPS)
• Pelvic Health Patient History Intake Form
• Pelvic Self-Exam for Telehealth