Sierra Rheumatology
Disease activity

RAPID 3 — Disease Activity Questionnaire

A 13-item self-assessment used to track rheumatoid arthritis activity over time.

About this form

The Rapid Assessment of Patient Index Data (RAPID3) measures physical function, pain, and overall health. Please complete this in our waiting room before your visit, or at home if your provider asked you to.

About 5 minutes
Progress
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Section 1 · Physical function

Please check the one best answer for your abilities at this time.

a. Dress yourself, including tying shoelaces and doing buttons *
b. Get in and out of bed *
c. Lift a full cup or glass to your mouth *
d. Walk outdoors on flat ground *
e. Wash and dry your entire body *
f. Bend down to pick up clothing from the floor *
g. Turn regular faucets on and off *
h. Get in and out of a car, bus, train, or airplane *
i. Walk two miles or three kilometers, if you wish *
j. Participate in recreational activities and sports as you would like, if you wish *
k. Get a good night's sleep
l. Deal with feelings of anxiety or being nervous
m. Deal with feelings of depression or feeling blue
Section 2 · Pain
How much pain have you had because of your condition over the past week? *
0 — No pain10 — Pain as bad as it could be
Section 3 · Global health
Considering all the ways in which illness and health conditions may affect you at this time, how do you feel overall? *
0 — Very well10 — Very poorly
Sign & submit

Submitting transmits this form securely to our office. For urgent medical issues please call our office or 911.

Trouble with the form?

Call our office and we'll either walk you through it or send a paper version.

Call (916) 677-4744← All forms