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Home Based Falls Prevention Program Medical Authorization Form TO BE COMPLETED BY CLIENT? S NAME: AGE: D.O.B. (Please Print) ADDRESS: PHONE: (H) PHONE: (Mob) EMERGENCY CONTACT: Phone: NAME OF DOCTOR:

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What is home based falls prevention?

Home based falls prevention refers to strategies and measures taken to reduce the risk of falls in the home environment, such as modifying the layout, installing safety equipment, and implementing exercise programs.

Who is required to file home based falls prevention?

There is no specific filing requirement for home based falls prevention. However, healthcare professionals, caregivers, and individuals themselves can take proactive steps to implement falls prevention measures in the home.

How to fill out home based falls prevention?

Filling out home based falls prevention involves assessing the home for potential fall hazards, implementing necessary modifications or safety measures, and creating an individualized falls prevention plan. This may include seeking guidance from healthcare professionals or utilizing resources provided by relevant organizations.

What is the purpose of home based falls prevention?

The purpose of home based falls prevention is to reduce the incidence of falls and associated injuries in the home environment, particularly among individuals who are at a higher risk of falling, such as older adults or people with certain medical conditions. By implementing preventive measures, the goal is to create a safer home environment and improve overall safety.

What information must be reported on home based falls prevention?

There is typically no formal reporting requirement for home based falls prevention. However, it is important to keep records of any modifications made, safety equipment installed, or falls prevention programs implemented. This information can help track progress, identify effectiveness, and guide future prevention efforts.

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