Upper Extremity Functional Scale

Upper Extremity Functional Scale (UEFS)

We are interested in knowing whether you are having any difficulty at all with the activities listed below because of your upper limb problem for which you are currently seeking attention. Please provide an answer for each activity.

Today, do you or would you have any difficulty at all with:

Thank you for taking the time to fill out this form.

Cann Chiropractic Center

Address

3076 East Chandler Heights Rd., Se. 107,
Gilbert, AZ 85298

Monday  

9:00 am - 6:00 pm

Tuesday  

9:00 am - 3:00 pm

Wednesday  

9:00 am - 6:00 pm

Thursday  

8:30 am - 4:00 pm

Friday  

8:30 am - 4:00 pm

Saturday  

Closed

Sunday  

Closed

We look forward to hearing from you

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Please do not submit any Protected Health Information (PHI).