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Run: Neck Disability Index (NDI) Scoring Sheet

The Neck Disability Index (NDI) Scoring Sheet captures patient responses, calculates the total score, and translates results into a disability percentage and...

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Assessment Context

Assessment Date (required)

Date the NDI was completed.

Visit Type (required)

Select the point in care when the NDI was administered.

Patient Identifier (required)

Use the local medical record number or chart identifier. Do not enter SSN or other unnecessary PII.

Clinician Name (required)

Name of the clinician administering the form.

NDI Item Responses

Pain Intensity (required)

Personal Care (washing, dressing, etc.) (required)

Lifting (required)

Reading (required)

Headaches (required)

Concentration (required)

Work (required)

Driving (required)

Sleeping (required)

Recreation (required)

Scoring Summary

Total Score

Sum of the 10 item scores, range 0-50.

Disability Percentage

Calculated percentage disability based on the total score.

Clinical Interpretation (required)

Select the interpretation that best matches the calculated score.

Clinical Notes

Optional notes about patient-reported limitations, test conditions, or follow-up plan. Avoid unnecessary PII.

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