PASI Company First Name Last Name Date of Birth (dd/mm/yyyy) Head Percentage Affected * 0% 1-9% 10-29% 30-49% 50-69% 70-89% 90-100% Redness * Absent Mild Moderate Severe Very Severe Thickness * Absent Mild Moderate Severe Very Severe Scaling * Absent Mild Moderate Severe Very Severe Upper Limbs Percentage Affected * 0% 1-9% 10-29% 30-49% 50-69% 70-89% 90-100% Redness * Absent Mild Moderate Severe Very Severe Thickness * Absent Mild Moderate Severe Very Severe Scaling * Absent Mild Moderate Severe Very Severe Trunk Percentage Affected * 0% 1-9% 10-29% 30-49% 50-69% 70-89% 90-100% Redness * Absent Mild Moderate Severe Very Severe Thickness * Absent Mild Moderate Severe Very Severe Scaling * Absent Mild Moderate Severe Very Severe Lower Limbs Percentage Affected * 0% 1-9% 10-29% 30-49% 50-69% 70-89% 90-100% Redness * Absent Mild Moderate Severe Very Severe Thickness * Absent Mild Moderate Severe Very Severe Scaling * Absent Mild Moderate Severe Very Severe Your PASI score is: From this baseline PASI90 is: From this baseline PASI75 is: