Get Daily Living Activities (dla20)-id/iddmoderate

This guide provides comprehensive instructions for completing the Daily Living Activities (DLA20)-ID/IDDModerate form online. By following these steps, users can effectively represent their or their consumer's daily living activities to secure necessary assistance.

Follow the steps to complete the DLA20 online.

1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling out the 'Consumer Name' and 'Consumer ID' fields at the top of the form. Ensure accurate spelling and use the consumer's preferred name.
3. Proceed to assess each of the 20 Daily Living Activities listed in the form. For each activity, evaluate and select a score that represents the consumer's independence and performance over the last 30 days.
4. Refer to the provided scoring scale to assign a score between 1 and 7 based on the frequency or quality of independent performance. If the consumer's functioning varies, rate the lowest score.
5. For any activity that could not be assessed, enter 'N/A' in the corresponding field. Remember not to rate more than 5 items as N/A.
6. Once all activities have been rated, calculate the total from the applicable scores. Divide this total by the number of activities rated to determine the average DLA-20 score.
7. Check the crosswalk provided for the average DLA-20 scores to understand the severity of illness and the level of impairment in functioning.
8. After reviewing all entered information for accuracy, you can save your changes, download the completed form, print it out, or share it as needed.

Complete your Daily Living Activities (DLA20) form online today to ensure accurate representation of needs.