RAPID 3 — Routine Assessment of Patient Index Data

A 13-item self-assessment used to track rheumatic disease activity over time.

About this form

The RAPID3 includes a subset of core variables found in the Multi-dimensional HAQ (MD-HAQ). It captures physical function (Section 1), patient global assessment for pain (Section 2), and patient global assessment for overall health (Section 3). Your provider will tally the score after you submit.

About 5 minutes

Progress

Patient information

Name *Date of birth *

1. PLEASE CHECK THE ONE BEST ANSWER FOR YOUR ABILITIES AT THIS TIME

OVER THE LAST WEEK, were you able to:

Activity	With some difficulty	With much difficulty	Unable to do
a. Dress yourself, including tying shoelaces and doing buttons?	1	2	3
b. Get in and out of bed?	1	2	3
c. Lift a full cup or glass to your mouth?	1	2	3
d. Walk outdoors on flat ground?	1	2	3
e. Wash and dry your entire body?	1	2	3
f. Bend down to pick up clothing from the floor?	1	2	3
g. Turn regular faucets on and off?	1	2	3
h. Get in and out of a car, bus, train, or airplane?	1	2	3
i. Walk two miles or three kilometers, if you wish?	1	2	3
j. Participate in recreational activities and sports as you would like, if you wish?	1	2	3
k. Get a good night's sleep?Informative only — not scored	1.1	2.2	3.3
l. Deal with feelings of anxiety or being nervous?Informative only — not scored	1.1	2.2	3.3
m. Deal with feelings of depression or feeling blue?Informative only — not scored	1.1	2.2	3.3

Sign & submit

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Submitting transmits this form securely to our office. Export to PDF works even with partial answers — useful if you want a printed copy to bring in. For urgent medical issues, please call our office or 911.

Trouble with the form?

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