The TSWF Low Back Pain-CPG AIM form is intended for use when seeing patients with low back pain in the primary care setting. The form’s embedded tools and links assist in HEDIS and DoD CPG compliance, and excellence in clinical medicine.

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Training Material for All Users

AHLTA and other training resources

Additional TSWF support

LBP Recent Changes

  • 18 changes for Jan-Apr 2018 update
  • Included revised LBP VA/DoD CPG diagram
  • Updated Diagnostic Workup table
  • Replaced the Follow-up Management diagram with the revised LBP VA/DoD diagram
  • Updated the interventions on Initial and F/U tabs
  • Added table of CPG recommendations
  • Added a clinical cue to the Family History text box (“Including, but not limited to, diabetes, heart disease, HTN, colon cancer, breast cancer, and/other cancers, and conditions that run in the family.”)
  • Added a clinical cue to the PHQ-9 ribbon (“If clinical judgement suggests, and/or patient is on anti-depressants and has a history of depression, skip PHQ-2, open ribbon, and go directly to PHQ-9.”)
  • Changed ribbon wording to: Depression Screening (PHQ-2 and PHQ-9)
  • Renamed the “Sexual Assault Toolkit” ribbon as “Sexual Assault Resources”
  • Removed the Overall Health question
  • Removed Secure Messaging question from Annual Questions field
  • Added REALM SF details and words to the forms (listed individually)
  • Placed the REALM SF scoring chart to the right of the text box with instruction:
    “The score is based on the number of words correctly read aloud.”
  • Consolidated MSK upper and lower into one tab
  • Reformatted Red Flags field
  • Moved Lifestyle/Exercise questions to Exit CCP tab
  • AUDIT-C revision:
    -Deleted previous AUDIT-C score field
    -Added AUDIT-C score to the existing date field
    -Reformatted clinical information
  • Deleted the Allergies field and added blue cue text explaining the change


  • Integrates VA/DoD CPGs
  • Provides accessible references
  • Assists in appropriate treatment and referrals

The TSWF-LBP-CPG AIM form has been designed to help PCMs standardize and optimize the approach to care of low back pain for MHS patients. The form integrates recommendations from VA/DoD CPGs, provides easily-accessible references for clinical decision making, and improves continuity of care and healthcare outcomes. Generally, low back pain is the fifth most common reason for outpatient visits in the USA, and it impacts mission readiness of the military. Using the TSWF-LBP CPG AIM form can help support evaluation, management, and documentation of patients with this common and far-reaching condition.

Form Lead

TSWF-LBP Form Lead
Donald W. Rumbaugh, M.D., DABFP

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