Sierra Rheumatology Inc.

2207 Plaza Drive, Suite 100,  Rocklin, CA 95765

Telephone: (916) 677-4744 Fax: (916) 781-2029 

www.sierrarheumatology.com

Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)

BASDAI Form

Rate 1 (none) - 10 (vert severe)

Rate 1 (none) - 10 (vert severe)

Rate 1 (none) - 10 (vert severe)

Rate 1 (none) - 10 (vert severe)

Rate 1 (none) - 10 (vert severe)

0 - 1/4 - 1/2 - 3/4 - 1 - 1 1/4 - 1 1/2 - 1 3/4 - 2 hours or more

FINANCIAL RESPONSIBILITY:

Our office will contact your insurance company, and the necessary arrangements will be made for approval of the medication and administration. You may want to follow up with your insurance company also to be sure everything is covered.
Our office does NOT provide a guarantee of coverage for any of these services. If coverage is not provided, YOU WILL BE RESPONSIBLE for any charges incurred for treatment and/or follow-up care.

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