PASI calculation and body diagram - face, hand and foot form (PB114)

Use this form if your patient has severe chronic plaque psoriasis of the face, or a palm of a hand, or a sole of a foot.

PASI is the Psoriasis Area and Severity Index.

This form can be uploaded through HPOS. Read more about form upload in HPOS.
This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.

Page last updated: 13 February 2019