Are you evaluating an older adult?

Number of falls within the past 12 months

Does the patient have an abnormality of gait or balance?

Is the patient being evaluated as a result of a fall?

Have you evaluated the patient for ...

• a history of falls and fall-related injuries?

• risk for osteoporosis?

• the person's functional ability?

• fear related to falling?

• visual impairment?

• evaluation for cognitive impairment?

• urinary or fecal incontinence?

• identification of home hazards that may contribute to falls?

• a review of current medications?

• health problems that may increase the risk of falling?

• a history of syncope?

• a review of footwear?

Have you performed ...

• a cardiovascular exam?

• a neurological exam?

• an assessment of muscle strength?

• an assessment of gait, balance and mobility?


Please fill out required fields.