Make Appointment - Health Link Wellness

Appointment Form

Please provide complete information so that the doctor can assess your symptoms before consulting.

Appointment

Personal Information
Pain of Osteoarthritis of the knee
Knees Score
Modified WOMAC Scale for Knee Pain
Daily Routine Assessment
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Instructions : Please rate the activities in catezory according to the following scale of dificulty:

0 = None 1 = Slight 2 = Moderate 3 = Very 4 = Extremely

Physical Function

	None	Slight	Moderate	Very	Extremely
1. Descending Stairs
2. Ascending stairs
3. Rising from sitting
4. Standing
5. Bending to floor
6. Walking on fiat surface
7. Getting in/out of car
8. Going shopping
9. Putting on socks
10. Lying in bed
11. Taking off socks
12. Rising from bed
13. Getting in/out bath
14. Sitting
15. Getting on/off toilet
16. Heavy domestic duties
17. Light domestic duties

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Health Link Clinic

Knee Osteoarthritis Clinic
is dedicated to providing you with
attentive care and dedication.

Address

Health Link Clinic. The Bright Rama 2 Shopping Center No. 15/9, 2nd Floor, Room B221, Rama 2 Road, Tha Kham Subdistrict, Bang Khun Thian District, Bangkok 10150, Thailand
Tel: 064-649-4629