Get Fall Risk Factors Checklist

The Fall Risk Factors Checklist is an essential tool for assessing an individual's risk of falling. By accurately completing this checklist online, you can contribute to a comprehensive evaluation of health and safety needs.

Follow the steps to complete the checklist easily and efficiently.

1. Click ‘Get Form’ button to obtain the checklist and open it in the digital editor.
2. Begin filling out the form by entering the patient's name and date at the top of the checklist.
3. In the 'Falls History' section, indicate whether the patient has experienced any falls in the past year. Select 'Yes' or 'No' accordingly.
4. Next, assess the patient's concerns regarding falling. Mark 'Yes' if they worry about falling or feel unsteady when standing or walking.
5. For the 'Medical Conditions' section, check 'Yes' or 'No' for each listed condition based on the patient's history, including heart rate problems, cognitive impairment, incontinence, depression, foot issues, and any other medical conditions that need specifying.
6. Move to the 'Medications' category. Here, determine if the patient is taking any CNS or psychoactive medications, medications that cause sedation or confusion, or those that might lead to hypotension. Mark each condition as present or absent.
7. Proceed to evaluate the patient's balance, strength, and gait using the standardized tests provided (Timed Up and Go Test, 30-Second Chair Stand Test, and 4-Stage Balance Test). Select 'Yes' or 'No' based on the results.
8. Assess visual acuity and the presence of postural hypotension within the designated areas. Answer appropriately using the options given.
9. Finally, if there are other risk factors to consider, specify them in the provided section and select 'Yes' or 'No' as applicable.
10. Once all sections are complete, ensure to save your changes. You can then download, print, or share the completed checklist as needed.

Start completing the Fall Risk Factors Checklist online to ensure accurate assessment and care.