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Patient Code Date Fall Risk Reassessment This questionnaire is intended to provide you with an indication as to your level of risk for having a debilitating fall. In each section, assess yourself
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How to fill out fall risk self-assessment

How to fill out fall risk self-assessment
01
Step 1: Begin by gathering the necessary materials, which may include a fall risk self-assessment form, a pen or pencil, and any relevant medical records.
02
Step 2: Find a quiet and comfortable space where you can focus on the task at hand.
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Step 3: Carefully read through each question on the fall risk self-assessment form.
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Step 4: Take your time to reflect on your own health and abilities in relation to each question.
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Step 5: Answer each question honestly and to the best of your knowledge.
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Step 6: If you are unsure about any question, seek clarification or assistance from a healthcare professional.
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Step 7: Double-check your answers for accuracy and completeness.
08
Step 8: Once you have completed filling out the fall risk self-assessment form, review it again to ensure accuracy.
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Step 9: If required, sign and date the form as instructed.
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Step 10: Submit the form as per the given instructions, whether it's sending it digitally or in person.
Who needs fall risk self-assessment?
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Fall risk self-assessment is important for individuals who are concerned about their risk of falling.
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It is particularly relevant for older adults, as falls are more common in this age group due to factors such as decreased mobility, muscle weakness, and medical conditions.
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Individuals who have experienced a fall in the past or have risk factors such as balance issues, medication side effects, or a history of osteoporosis should also consider undergoing a fall risk self-assessment.
04
Additionally, healthcare professionals may recommend fall risk self-assessment for patients who are undergoing certain medical treatments or have specific health conditions that increase the risk of falls.
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