SF529

MUSCLE FUNCTION BY NERVE DISTRIBUTION: Trunk and Lower Extremity

Agency
GSA
Revision
Rev. 4/1994
Fillable fields
221
Pages
2
Official source
GSA form page
Checked
October 20, 2026
Fill SF529 online
Page 1 of form SF529

Standard Form 529 (SF 529): Muscle Function by Nerve: Trunk and Lower Extremity

Standard Form 529 (SF 529), Muscle Function by Nerve Distribution: Trunk and Lower Extremity, is a two-sided medical record printed as SF Form 529 (Rev. 4-94). The footer of the front names the General Services Administration, and GSA hosts a copy in its forms library. The form prints no prescribing regulation.

The front holds the problem and brief clinical history, a key to manual muscle evaluation, and rows of trunk and leg muscles grouped under their nerves, from the inferior gluteal nerve to the common peroneal nerve, each with spinal levels such as L4-5, S1 printed beside it. The back is a single ADDITIONAL COMMENTS page.

The PDF prints no instructions. You can fill it out free in your browser on this page and download the result without an account.

Top of page 1 of Standard Form 529 (SF 529): Muscle Function by Nerve: Trunk and Lower Extremity, as printed by GSA

What's on SF 529

History and muscle key

A PROBLEM AND BRIEF CLINICAL HISTORY block and a KEY TO MANUAL MUSCLE EVALUATION from 100% 5 N Normal down to 0% 0 0 Zero.

Trunk muscles

Erector spinae, Rectus Abd., the external and internal obliques and Quad. Lumborum, each with its spinal levels, such as T5-11 for Rectus Abd.

Hip and thigh nerves

Muscles under the inferior and superior gluteal, femoral, obturator and sciatic nerves, including Gluteus Max., Quadriceps, Hip Adductors and Biceps Fem.

Lower leg and foot nerves

Muscles under the posterior tibial nerve, from Gastrocnemius to Lumbricales, and the common peroneal nerve, from Tibialis Ant. to Peroneus Tert.

Comments, signature and identification

A COMMENTS column, SIGNATURE and DATE rows, the patient's identification, and register and ward numbers.

Back: additional comments

The back is one open area headed ADDITIONAL COMMENTS, marked SF Form 529 (Rev. 4-94) Back.

How to fill out SF 529

  1. 1

    Write the history

    Fill in the problem and brief clinical history at the top of the front.

  2. 2

    Date the column and side

    Enter the date and the side tested at the head of a column.

  3. 3

    Grade each muscle

    Enter results in the row for each muscle. The key on the front gives the grades 5 N, 4 G, 3 F, 2 P, 1 T and 0.

  4. 4

    Comment and sign

    Use the COMMENTS column, and the ADDITIONAL COMMENTS page on the back if needed, then sign and date in the SIGNATURE and DATE rows.

  5. 5

    Identify the patient

    Complete the patient's identification with the register and ward numbers at the foot of the front.

These steps follow the order of the blocks on the two pages.

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Where it goes and what the form says

Where it goes

The PDF prints no filing address. It is labeled Medical Record, and the identification block names the hospital or medical facility.

Issuer and edition

The footer of the front reads GENERAL SERVICES ADMINISTRATION and SF Form 529 (Rev. 4-94). GSA's page lists a current revision date of 06/1994 and leaves the authority blank.

Instructions and privacy

The PDF prints no instructions, Privacy Act statement or burden estimate.

Related forms

Who fills out SF 529?

  • The person who signs

    The front has SIGNATURE and DATE rows below the COMMENTS column. The form does not name a role for the signer.

  • Dated test columns

    A DATE row and an INDICATE SIDE TESTED row, each marked with an arrow, head six columns of boxes beside the muscle rows.

  • The patient, as identified

    The patient does not sign. The identification block takes name (last, first, middle), grade, SSN, rank, rate, and hospital or medical facility.

  • The medical facility

    The form is labeled Medical Record and carries REGISTER NO. and WARD NO. boxes beside the patient's identification.

The form prints no instructions. Its blocks show who signs and whose record it is.

Official sources and the blank

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Questions about Form SF529

Who issues SF 529?

The footer of the front names the General Services Administration and reads SF Form 529 (Rev. 4-94). GSA hosts a copy in its forms library.

Which edition is SF 529?

The PDF prints Rev. 4-94. GSA's page lists a current revision date of 06/1994.

How is SF 529 organized?

Trunk muscles come first, then leg muscles grouped under the nerve that supplies them, such as the femoral, sciatic, posterior tibial and common peroneal nerves, with spinal levels printed beside each muscle.

Who signs SF 529?

The front has SIGNATURE and DATE rows. The form does not name a role for the signer.

Does SF 529 come with instructions?

No. The PDF prints only the form's labeled blocks, the muscle key and an additional comments page.