Cumberland Ankle Instability Tool
23 reviews
32K+
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Use our readymade template to create your Cumberland Ankle Instability Tool (CAIT) for assessing the severity of functional ankle instability

Create your care assessments

CAIT score Ankle Instability Severity
28-30 None
24-27 Mild
19-23 Moderate
0-18 Severe
  • navigate_next 9-item questionnaire that scores each item on a scale, with a total score ranging from 0 to 30
  • navigate_next Real-time calculation of CAIT Score based on the form responses
  • navigate_next Collect patient data and other sensitive healthcare data using our HIPAA compliant online assessment forms
  • navigate_next Compare the scores from the initial screening with that of the followup to track the progression of ankle instability
  • navigate_next Easily create responsive forms that allow patients to complete their assessments on any device at any time

Collect responses from your patients

Patient ID 1004
Patient Name John W
Patient Email johnw@ymail.com
Patient Phone Number 0987654321
Doctor's Name Dr. Smith
Location New York
1. I have pain in my ankle During sport
2. My ankle feels UNSTABLE Sometimes during sport (not every time)
3. When I make SHARP turns, my ankle feels UNSTABLE Somtimes when running
4. When going down the stairs, my ankle feels UNSTABLE If I go fast
5. My ankle feels UNSTABLE when standing on ONE leg On the ball of my foot
6. My ankle feels UNSTABLE when I hop from side to side
7. My ankle feels UNSTABLE when I run on uneven surfaces
8. TYPICALLY, when I start to roll over (or “twist”) on my ankle, I can stop it Immediately
9. After a TYPICAL incident of my ankle rolling over, my ankle return to "normal" Almost immediately
CAIT Score 26
  • navigate_next Pre-populate patient details such as patient id, name, email etc in the CAIT assessment form before sharing it with the patients
  • navigate_next Send an email invitation with a secure link for patients to complete their CAIT assessment form prior to their visit
  • navigate_next Allow patients to save their progress and complete their CAIT assessment form at a later time without losing any responses
  • navigate_next Set up an email template for your CAIT assessment and automatically send invitation emails to multiple patients with ease
  • navigate_next Send a confirmation email to the patients with their CAIT score, diagnosis, next steps when they submit their CAIT assessment

Track patient responses in Google Sheets

A B C D E
1 Name Question Answer Score Total Score
2 John W 1. I have pain in my ankle During sport 4 26
3 John W 2. My ankle feels UNSTABLE Sometimes during sport (not every time) 3 26
4 John W 3. When I make SHARP turns, my ankle feels UNSTABLE Somtimes when running 2 26
5 John W 4. When going down the stairs, my ankle feels UNSTABLE If I go fast 2 26
6 John W 5. My ankle feels UNSTABLE when standing on ONE leg On the ball of my foot 1 26
7 John W 6. My ankle feels UNSTABLE when I hop from side to side 2 26
8 John W 7. My ankle feels UNSTABLE when I run on uneven surfaces 3 26
9 John W 8. TYPICALLY, when I start to roll over (or “twist”) on my ankle, I can stop it Immediately 3 26
10 John W 9. After a TYPICAL incident of my ankle rolling over, my ankle return to "normal" Almost immediately 3 26
  • navigate_next Export patient responses including the calculated CAIT score to Google Sheets for easy record-keeping
  • navigate_next Export individual points for each item to Google Sheets for data manipulation and analysis for comprehensive insights
  • navigate_next Use pre-built reports to easily keep track of patient progress over time and monitor changes in their ankle instability symptoms
  • navigate_next Receive a copy of the response and the calculated CAIT score by email whenever a patient submits their CAIT assessment
  • navigate_next Use data in Google Sheets to integrate with external EHR systems for seamless data transfer

HIPAA compliance

Patient ID: 1004
Patient Name: ******
Patient Email: ******
Patient Phone Number: ******
Doctor's Name: Dr. Smith
Location: New York
1. I have pain in my ankle : During sport
2. My ankle feels UNSTABLE: Sometimes during sport (not every time)
3. When I make SHARP turns, my ankle feels UNSTABLE: Somtimes when running
4. When going down the stairs, my ankle feels UNSTABLE: If I go fast
5. My ankle feels UNSTABLE when standing on ONE leg: On the ball of my foot
6. My ankle feels UNSTABLE when: I hop from side to side
7. My ankle feels UNSTABLE when: I run on uneven surfaces
8. TYPICALLY, when I start to roll over (or “twist”) on my ankle, I can stop it: Immediately
9. After a TYPICAL incident of my ankle rolling over, my ankle return to "normal": Almost immediately
CAIT Score: 26
CAIT Score: 26
  • navigate_next Create a HIPAA compliant CAIT assessment form to safely collect, store and access patient responses
  • navigate_next Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI
  • navigate_next Automatically mask PHI fields when exporting CAIT form responses to Google Sheets and sending them on email
  • navigate_next Prepopulate patient details in CAIT assessments by creating secure prefill links without exposing PHI
  • navigate_next Limit access to patient data only for authorized personnel and minimize the risk of data breaches

These reviews are reproduced without modification from Google Workspace Marketplace.

July 27, 2023

5 stars

I am 100% a fan of this company. We use HIPAA compliant Google Forms and needed a way to collect signatures, the industry standard company is TOO expensive. I started using FormEsign and it worked perfectly. It lacked the ability to provide a pdf copy of the form after signature. This company worked with me help their product evolve into something that could benefit all future clients AND the end user. The team was polite, professional, kind, enthusiastic, and willing to make a change. This earned my loyalty. I will sing their praises. Good work, and thank you!

— Royal Bush

July 23, 2023

5 stars

I am not tech savvy. I chose formesign to help create registration links for clients. Vipid has been great in assisting me. He goes above and beyond. My company now has moved from the stone age to modern age through the ability to use this feature. Of the many features I am impressed with, the ability to update a form without needing to regenerate a link is amazing. I often make mistakes and that ability allows me to fix mistakes without needing to change everything. Thank you!!!

— Sol Evans

October 31, 2023

5 stars

We needed a way to create forms with e-signatures and this app made it very easy. Support is also very quick and always helpful. Cannot recommend enough!

— Chris Henesy

February 16, 2024

1 stars

Does not work

— Myles Sicuro

July 12, 2023

5 stars

It very friendly to used. I love it. For my case multiple signature needed. it's supporting

— Senthil Kumar

November 27, 2023

5 stars

Yeah this is good for all

— luqman Khan

July 10, 2023

5 stars

We were looking for a way to have a signature option in our form. Formesign addon allowed us to collect signatures for the acknowledgment and consent forms. It was simple and easy to setup. Very useful addon for google forms.

— Joan S

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