Recovery Tracker

Name

First

Last

Date / Time

Phone

Operating Doctor

Surgery Type

Survey Surgery Doctor

HASTI Survey

	None - 1	Mild - 2	Moderate - 3	Strong - 4	Severe - 5
Heaviness	None - 1Heaviness None - 1	Mild - 2Heaviness Mild - 2	Moderate - 3Heaviness Moderate - 3	Strong - 4Heaviness Strong - 4	Severe - 5Heaviness Severe - 5
Achiness	None - 1Achiness None - 1	Mild - 2Achiness Mild - 2	Moderate - 3Achiness Moderate - 3	Strong - 4Achiness Strong - 4	Severe - 5Achiness Severe - 5
Swelling	None - 1Swelling None - 1	Mild - 2Swelling Mild - 2	Moderate - 3Swelling Moderate - 3	Strong - 4Swelling Strong - 4	Severe - 5Swelling Severe - 5
Throbbing	None - 1Throbbing None - 1	Mild - 2Throbbing Mild - 2	Moderate - 3Throbbing Moderate - 3	Strong - 4Throbbing Strong - 4	Severe - 5Throbbing Severe - 5
Itching	None - 1Itching None - 1	Mild - 2Itching Mild - 2	Moderate - 3Itching Moderate - 3	Strong - 4Itching Strong - 4	Severe - 5Itching Severe - 5

Help with HASTI

Heaviness: (That feeling when your e.g. legs seem heavier than usual, like they’re tired or hard to move)
Achiness: (A dull, nagging discomfort in your e.g. legs, like they’re sore or tired)
Swelling: (Visible or physical swelling in the legs)
Throbbing: (A pulsing or beating feeling, coming in waves)
Itching: (Irritation or itching in the affected area)

Picture Upload

Drag & Drop Files, Choose Files to Upload You can upload up to 2 files.

Optional: Upload an image of the affected area.

Comment or Message

Recovery Tracker

Name

First

Last

Date / Time

Phone

Operating Doctor

Surgery Type

HASTI Survey

	None - 1	Mild - 2	Moderate - 3	Strong - 4	Severe - 5
Heaviness	None - 1Heaviness None - 1	Mild - 2Heaviness Mild - 2	Moderate - 3Heaviness Moderate - 3	Strong - 4Heaviness Strong - 4	Severe - 5Heaviness Severe - 5
Achiness	None - 1Achiness None - 1	Mild - 2Achiness Mild - 2	Moderate - 3Achiness Moderate - 3	Strong - 4Achiness Strong - 4	Severe - 5Achiness Severe - 5
Swelling	None - 1Swelling None - 1	Mild - 2Swelling Mild - 2	Moderate - 3Swelling Moderate - 3	Strong - 4Swelling Strong - 4	Severe - 5Swelling Severe - 5
Throbbing	None - 1Throbbing None - 1	Mild - 2Throbbing Mild - 2	Moderate - 3Throbbing Moderate - 3	Strong - 4Throbbing Strong - 4	Severe - 5Throbbing Severe - 5
Itching	None - 1Itching None - 1	Mild - 2Itching Mild - 2	Moderate - 3Itching Moderate - 3	Strong - 4Itching Strong - 4	Severe - 5Itching Severe - 5

Help with HASTI

Heaviness: (That feeling when your e.g. legs seem heavier than usual, like they’re tired or hard to move)
Achiness: (A dull, nagging discomfort in your e.g. legs, like they’re sore or tired)
Swelling: (Visible or physical swelling in the legs)
Throbbing: (A pulsing or beating feeling, coming in waves)
Itching: (Irritation or itching in the affected area)

Picture Upload

Drag & Drop Files, Choose Files to Upload You can upload up to 2 files.

Optional: Upload an image of the affected area.

Email Operating Doctor

Comment or Message

Recovery TrackerCVVAdmin2025-03-31T21:15:49-04:00

Recovery Tracker

Operating Surgery Layout

Name

First

Last

Date / Time

Phone

Operating Doctor

Surgery Type

HASTI Survey

	None - 1	Mild - 2	Moderate - 3	Strong - 4	Severe - 5
Heaviness	None - 1Heaviness None - 1	Mild - 2Heaviness Mild - 2	Moderate - 3Heaviness Moderate - 3	Strong - 4Heaviness Strong - 4	Severe - 5Heaviness Severe - 5
Achiness	None - 1Achiness None - 1	Mild - 2Achiness Mild - 2	Moderate - 3Achiness Moderate - 3	Strong - 4Achiness Strong - 4	Severe - 5Achiness Severe - 5
Swelling	None - 1Swelling None - 1	Mild - 2Swelling Mild - 2	Moderate - 3Swelling Moderate - 3	Strong - 4Swelling Strong - 4	Severe - 5Swelling Severe - 5
Throbbing	None - 1Throbbing None - 1	Mild - 2Throbbing Mild - 2	Moderate - 3Throbbing Moderate - 3	Strong - 4Throbbing Strong - 4	Severe - 5Throbbing Severe - 5
Itching	None - 1Itching None - 1	Mild - 2Itching Mild - 2	Moderate - 3Itching Moderate - 3	Strong - 4Itching Strong - 4	Severe - 5Itching Severe - 5

Help with HASTI

Heaviness: (That feeling when your e.g. legs seem heavier than usual, like they’re tired or hard to move)
Achiness: (A dull, nagging discomfort in your e.g. legs, like they’re sore or tired)
Swelling: (Visible or physical swelling in the legs)
Throbbing: (A pulsing or beating feeling, coming in waves)
Itching: (Irritation or itching in the affected area)

Picture Upload

Drag & Drop Files, Choose Files to Upload You can upload up to 2 files.

Optional: Upload an image of the affected area.

Comment or Message

Recovery Tracker

Layout Upload Name

Name

First

Last

Date / Time

Phone

Operating Doctor

Surgery Type

HASTI Survey

	None - 1	Mild - 2	Moderate - 3	Strong - 4	Severe - 5
Heaviness	None - 1Heaviness None - 1	Mild - 2Heaviness Mild - 2	Moderate - 3Heaviness Moderate - 3	Strong - 4Heaviness Strong - 4	Severe - 5Heaviness Severe - 5
Achiness	None - 1Achiness None - 1	Mild - 2Achiness Mild - 2	Moderate - 3Achiness Moderate - 3	Strong - 4Achiness Strong - 4	Severe - 5Achiness Severe - 5
Swelling	None - 1Swelling None - 1	Mild - 2Swelling Mild - 2	Moderate - 3Swelling Moderate - 3	Strong - 4Swelling Strong - 4	Severe - 5Swelling Severe - 5
Throbbing	None - 1Throbbing None - 1	Mild - 2Throbbing Mild - 2	Moderate - 3Throbbing Moderate - 3	Strong - 4Throbbing Strong - 4	Severe - 5Throbbing Severe - 5
Itching	None - 1Itching None - 1	Mild - 2Itching Mild - 2	Moderate - 3Itching Moderate - 3	Strong - 4Itching Strong - 4	Severe - 5Itching Severe - 5

Help with HASTI

Heaviness: (That feeling when your e.g. legs seem heavier than usual, like they’re tired or hard to move)
Achiness: (A dull, nagging discomfort in your e.g. legs, like they’re sore or tired)
Swelling: (Visible or physical swelling in the legs)
Throbbing: (A pulsing or beating feeling, coming in waves)
Itching: (Irritation or itching in the affected area)

Picture Upload

Drag & Drop Files, Choose Files to Upload You can upload up to 2 files.

Optional: Upload an image of the affected area.

Comment or Message