Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Multi-State Forms
  • 6cit Printable Form

Get 6cit Printable Form

Page 1 of 2 Six Item Cognitive Impairment Test (6CIT) The 6 Item Cognitive Impairment Test (6CIT) Kingshill Version 2000 was developed in 1983, 1 by regression analysis of the Blessed Information.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the 6cit Printable Form online

The 6 Item Cognitive Impairment Test (6CIT) is a valuable tool for dementia screening in primary care settings. This guide provides comprehensive instructions for filling out the 6CIT Printable Form online, ensuring that users can complete the assessment effectively.

Follow the steps to successfully complete the 6CIT Printable Form online.

  1. Click the ‘Get Form’ button to access the 6CIT Printable Form and open it in your preferred editing tool.
  2. Begin with the first question: 'What year is it?' Enter the correct year. A correct answer scores 0 points, while an incorrect answer scores 4 points.
  3. Proceed to question two: 'What month is it?' Again, provide the correct month. Correct answers score 0 points, while incorrect answers score 3 points.
  4. For question three, provide an address phrase consisting of five components, for example, 'John, Smith, 42, High St, Bedford.'
  5. Next, answer question four: 'About what time is it (within 1 hour)?' A correct answer scores 0 points, and an incorrect answer scores 3 points.
  6. For question five, count backwards from 20 to 1. Errors will affect your score: no errors score 0 points, one error scores 2 points, and more than one error scores 4 points.
  7. Lastly, for question six, recite the months of the year in reverse. Similar to question five, scoring is based on the number of errors.
  8. Finally, repeat the address phrase from question three. Scoring here is based on the number of errors in the repetition.
  9. After completing all questions, calculate the total score. Enter your total score out of 28 in the designated field.
  10. Once you have filled out the form completely, remember to save your changes. You can also download, print, or share the form as needed.

Start completing your 6CIT Printable Form online today to support dementia screening efforts.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

Agency Tracking ID:PGC2110065 Authorization Number...
Apr 2, 2012 — FCC:Success:Form 159 - PRINTABLE VERSION. Page 1 of 1 ... 6) CIT" f(7)...
Learn more
Cognitive Assessment Toolkit - Alzheimer's...
Short Form of the Informant Questionnaire on Cognitive Decline in the Elderly ( Short...
Learn more

Related links form

Brightstar BDP CAN2 2016 Brookhaven National Laboratory AMS-Form-010 2012 BS NIB Form B82 2017 BSA 34405 2019

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

Performing the 6CIT involves asking the individual a series of six specific questions designed to assess cognitive function. Ensure the participant understands each question and record their answers accurately. After completing the questions, score the responses to determine cognitive health. For easy administration and reference, the 6cit Printable Form is available on US Legal Forms.

The six questions on the dementia test typically focus on orientation, memory, and cognitive skills. They may ask about the current date, location, and personal history. These questions aim to evaluate the individual's cognitive health effectively. For a comprehensive overview, the 6cit Printable Form from US Legal Forms includes all necessary details.

The 6 item CIT is scored by evaluating the responses to each of the six questions. Each correct answer earns a point, and the total score helps determine the cognitive performance level. A higher score indicates better cognitive function, while lower scores may suggest potential memory issues. To easily access the scoring guidelines, consider using the 6cit Printable Form.

The 6CIT offers several benefits, including its simplicity and effectiveness in identifying cognitive issues early. It requires minimal time to administer and can be easily documented using the 6CIT Printable Form. This form not only aids in tracking an individual's cognitive health but also facilitates communication between caregivers and healthcare providers.

The three words typically used in memory tests are 'apple', 'table', and 'penny'. These words are simple and commonly known, making them effective for assessing memory recall. Incorporating the 6CIT Printable Form can help you record responses and track progress over time, aiding in a more thorough evaluation.

Stage 6 of dementia is characterized by advanced cognitive decline and significant memory loss. Individuals may struggle with daily tasks, recognize familiar faces, and may require assistance with personal care. Understanding this stage is crucial for caregivers, and using the 6CIT Printable Form can help monitor cognitive changes and plan appropriate care strategies.

A 6CIT test is a brief cognitive screening tool that assesses an individual's memory and thinking skills. This test can help detect early signs of cognitive decline. By utilizing the 6CIT Printable Form, you can ensure that the testing process is organized and efficient, allowing for clear record-keeping and analysis.

A 6CIT assessment is a tool designed to evaluate cognitive function, especially in older adults. It focuses on identifying memory issues and other cognitive impairments. The 6CIT Printable Form helps streamline this assessment process, making it easier for caregivers and healthcare professionals to document results and track changes over time.

The 6-CIT consists of 6 questions including temporal orientation, remembering an address, counting backwards from 20, and stating the months of the year in reverse. An inverse score is used, and questions are weighted to produce a total out of 28. Scores of 0–7 are considered normal and 8 or more significant.

Six-item Cognitive Impairment Test (6CIT) What year is it? Correct - 0 points. ... What month is it? Correct - 0 points. ... Give the patient an address phrase to remember with 5 components - ... About what time is it (within one hour)? ... Count backwards from 20-1. ... Say the months of the year in reverse. ... Repeat address phrase.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get 6cit Printable Form
Get form
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Your Privacy Choices
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
altaFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2026
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Your Privacy Choices
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
altaFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2026
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232