The Foot & Ankle Disability Index (FADI) Score

Please answer every question with one response that most closely describes your condition within the past week. If the activity in question is limited by something other Han your foot or ankle, mark N/A.

First Name(Required)

Last Name(Required)

Please answer every question with one response that most closely describes your condition within the past week.

	No difficulty	Slight difficulty	Moderate difficulty	Extreme Difficulty	Unable to do
Standing
Walking on even ground
Walking on even ground without shoes
Walking up hills
Going up stairs
Going down stairs
Walking on uneven ground
Stepping up and down curves
Squating
Sleeping
Coming up to your toes
Walking initially
Walking 5 Minutes or less
Walking approximately 10 minutes
Walking 10 minutes or greater
Walking 15 minutes or greater
Home responsibilities
Activities of Daily living
Personal Care
Light to moderate work (standing, walking)
Heavy work (push/pulling, climbing, carrying)
Recreational activities

Thank you very much for completing all the questions in this questionnaire.

	No Pain	Mild	Moderate Severe	Severe	Unbearable
General level of pain
Pain at rest
Pain during your normal activity
Pain first thing in the morning