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Hip/knee score assessment

Hip/Knee Score Assessment
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What is your name?
What is your date of birth?
For example, 31 3 1980
What is your sex?
As recorded on your medical record
The one used to register with your GP
Anyone else with access to your email account may see responses sent to you
Confirmation Required

If you are using a UK mobile number, please use the format 07xxxxxxxxx

Please specify the joint affected:
Please specify which area is affected:

Please complete the following:

How bad is your hip/knee pain?
How bad is your night pain?
How far can you walk?
How often do you need painkillers?
Is your pain getting worse?
Are you prepared to consider major joint replacement surgery?
Are you a carer?
Do you rely on a carer?
Confirmation