• Elbow Tendinopathy Questionnaire

  • Format: (000) 000-0000.
  • Date of Birth **
     - -

  • Screening Questionnaire

  • Where is your pain?*
  • How long have you had pain for?*
  • How did the pain start?*
  • Does gripping or squeezing objects cause pain?*
  • Does lifting objects make your pain worse?*
  • Does twisting your forearm cause pain (like turning a screwdriver or door knob)?*
  • Does moving your wrist up and down cause pain?*
  • Worst pain Severity within the last week on scale of 0-10?*
  • When do you notice more pain?*
  • Does your elbow pain limit your ability to perform work, household, or recreational activities (including sports)?*
  • Is the pain in your dominant arm/hand?*
  • Have you had prior diagnosis and treatment for elbow pain?*
  • What treatments have you had for elbow pain (choose as many as needed)?

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