Get the free Walking Assessment Form - unc

Walking Suitability Assessment Form (V.021003 developed by James Emery, MPH UNC School of Public Health, Health Behavior and Health Education Data Collector Name: Date: Road Segment ID#: Road Name:

How to fill out walking assessment form

How to fill out walking assessment form:

1. Start by providing your personal information such as your name, age, and contact details.
2. Next, fill in your medical history including any existing conditions, injuries, or surgeries that may affect your walking abilities.
3. Indicate your current fitness level and any specific goals you have for improving your walking abilities.
4. Assess your walking technique by describing any issues you may have with posture, balance, or stride length.
5. Evaluate your walking environment, noting any obstacles, uneven surfaces, or other factors that may impact your walking.
6. Include any additional information or comments that you think may be relevant to the assessment.
7. Review the filled-out form to ensure all sections are completed accurately and legibly.

Who needs walking assessment form:

1. Individuals who have experienced walking difficulties due to injuries or medical conditions.
2. Elderly individuals who want to assess their walking abilities and prevent falls.
3. Athletes or individuals participating in sports or fitness activities that involve walking as a key component.
4. Physical therapists or trainers who are evaluating their clients' walking abilities for rehabilitation or training purposes.
5. Individuals who want to track their progress in walking as part of a fitness or wellness program.

For pdfFiller’s FAQs

What is walking assessment form?

Walking assessment form is a document that evaluates a person's walking ability and identifies any issues or limitations they may have while walking.

Who is required to file walking assessment form?

The walking assessment form must be filed by individuals who require an assessment of their walking ability, such as those undergoing physical therapy or rehabilitation programs.

How to fill out walking assessment form?

To fill out the walking assessment form, you need to provide accurate information about your walking abilities, any pain or limitations you experience while walking, and any relevant medical history. The form may also require the input of a healthcare professional or physical therapist.

What is the purpose of walking assessment form?

The purpose of the walking assessment form is to evaluate a person's walking ability and identify any issues or limitations they may have. This information can help healthcare professionals develop appropriate interventions or treatment plans.

What information must be reported on walking assessment form?

The walking assessment form typically requires information about the individual's walking ability, any pain or discomfort experienced while walking, the presence of mobility aids, and any relevant medical history or conditions.

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