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Subjective Global Assessment Form MEDICAL HISTORY Patient name: Date: / / NUTRIENT INTAKE 1. No change; adequate 2. Inadequate; duration of inadequate intake Suboptimal solid diet Full fluids or only
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How to fill out subjective global assessment form
How to fill out subjective global assessment form
01
Open the subjective global assessment form.
02
Start by entering the patient's demographic information.
03
Assess the patient's weight changes over time and record the information.
04
Evaluate the patient's dietary intake and document it accurately.
05
Measure and record the patient's gastrointestinal symptoms, if any.
06
Consider the patient's functional capacity and note it down.
07
Make a subjective assessment of the patient's overall appearance.
08
Assess the patient's subcutaneous fat stores and muscle wasting.
09
Determine the patient's presence of edema or fluid accumulation.
10
Summarize the information gathered to calculate the subjective global assessment score.
11
Record the score and provide any additional comments or observations.
12
Review the completed form for accuracy and completeness before submitting.
Who needs subjective global assessment form?
01
Healthcare professionals who want to evaluate a patient's nutritional status.
02
Patients who are at risk of malnutrition or weight loss.
03
Individuals undergoing treatment for severe illness or chronic disease.
04
Athletes or individuals following specific dietary plans who require monitoring.
05
Research studies or clinical trials assessing nutritional interventions.
06
Hospitals or healthcare facilities implementing nutritional assessment protocols.
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