Assessment Form
Patient Category
Patient Condition
Patient was lying on the bed, no carer around
Patient was lying on the bed, accompanied by family member
Patient was lying on the bed, accompanied by caregivers
Mobility mode:
Ambulation
Wheelchair
Ambulation:
Wheelchair:
1. Hand function
1. Prehension test
Affected Area
Whole Hand
Thumb
Index
Middle
Ring
Little
Palm
2. Cognitive
3. PAIN
Assessment Result:
(click to copy)
Client Needs and Priorities
Occ Therapy Modalities