First session intake

Gather essential patient medical history, injury details, and treatment goals before their initial physiotherapy session.

Hosted by Euan · 8 questions

Every question in this template

Euan asks each of these questions on video, in this order.

01
Where is the main problem?
Dropdown
Euan says: “Where in your body is the main problem you'd like help with?”
Neck · Upper back · Lower back · Shoulder · Elbow or wrist · Hip · Knee · Ankle or foot · Somewhere else
02
How did it start?
Multiple choice
Euan says: “How did this start? Was it an injury, surgery, or more gradual?”
A specific injury · After surgery · Gradually over time · Not sure
03
Show or describe what hurts
Video, voice or text answer
Euan says: “Record a quick video showing the movement that hurts, or just describe it.”
04
Pain at its worst this week
Star rating
Euan says: “From one to ten, how bad was the pain at its worst this week?”
05
What do you want to get back to?
Multiple choice
Euan says: “What would you most like to get back to doing?”
Daily tasks without pain · Sport or exercise · Work · Sleeping comfortably
06
Consent to store your answers
Consent
Euan says: “We only use your answers to prepare your session. Please confirm that's okay.”
07
Your contact details
Contact details
Euan says: “Last step. How should we reach you about your appointment?”
08
Which surgery did you have, and when?
Short answer
Euan says: “Which operation did you have, and roughly when was it?”