Get Cerebral Palsy Description Form Part I Motor Impairments - Kemh Health Wa Gov

Filling out the CEREBRAL PALSY DESCRIPTION FORM Part I MOTOR IMPAIRMENTS is a crucial process for documenting motor impairments associated with cerebral palsy. This guide provides a step-by-step approach to help users complete the form accurately and efficiently.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to access the document and open it in the form editor.
2. Begin by filling in the child’s name and date of birth (DOB) at the top section of the form. If a sticky label is available, attach it to this part for easier identification.
3. Enter the name of the examining clinician and the date of the examination in the specified fields.
4. For the question 'Is there spasticity in one or more limbs?', check the 'Yes' or 'No' box as appropriate. Continue this process for the remaining questions about muscle tone, ataxia, and hypotonia.
5. Utilize the stick figures provided in the form to describe limb muscle tone. Fill in the highest Australian Spasticity Assessment Scale (ASAS) score corresponding to the assessed limb's tone.
6. Number the movement abnormalities present in the child in order of predominance. Use the predefined categories such as spasticity, dystonia, and athetosis.
7. Provide a descriptive summary of the type and severity of cerebral palsy as you would document in a medical record.
8. Ensure that all required sections of the form are completed before reviewing your entries for accuracy and completeness.
9. Once completed, save changes to the form. You may choose to download, print, or share the document as needed.

Complete the CEREBRAL PALSY DESCRIPTION FORM online today to ensure accurate documentation of motor impairments.