Hypermobility Assessment Hypermobility Assessment Do you consider yourself flexible?* Very Flexible About Average Pretty Stiff Have you ever sprained your ankle or any other joint?* Yes Repeatedly No Can you bend over the touch the ground without bending your knees?* Easily Pretty Close Never Do you bruise easily?* Yes No Do you have pain in 2 or more areas that have been present for longer than 3 months?* More than 4 areas Yes, 2 areas No, not longer than 3 months Have you ever dislocated a joint?* Yes Yes, more than once No Do you scar easily with wide or thick scars?* Yes No Does your jaw ever lock or catch without traumatic injury?* Yes No Do you have trouble with your balance?* Yes, I am constantly bumping into things Sometimes, but only occasionally No, I am steady and haven’t noticed any problems with my balance Is your arm span longer than your height?* Yes No Can you sit with your legs out in front of you and lift your heels off the floor keeping your knees on the ground?* Yes, barely Yes, several inches No Can you use your other hand to bring your pinky finger back greater than 90 degrees?* Yes No Name* First Last Email* Last 4 digits of your Phone number*We ask this so we can clinically track your experience without collecting other identifying information allowing us to comply with HIPPA.
