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REGISTRATION FORM STUDENT NAME BIRTHDAY AGE SCHOOL GRADE CLASS# DAY TIME LEVEL TOTAL NUMBER OF HRS. CLASS# DAY TIME LEVEL REGULAR MONTHLY RATE CLASS# DAY TIME LEVEL ORLY REGISTRATION FEE (per family)
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How to fill out mini-cog instructions for administration

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How to fill out mini-cog instructions for administration

01
Step 1: Provide the participant with a sheet of paper and a pen.
02
Step 2: Explain the three-word recall task. Read out three simple words (e.g., apple, table, and penny) and tell the participant to remember them.
03
Step 3: Give the participant a blank clock face and ask them to draw numbers and hands to indicate a specific time (e.g., 10 minutes past 11).
04
Step 4: Ask the participant to recall the three words you mentioned earlier.
05
Step 5: Score the Mini-Cog by giving 0 points if the words are not recalled or if the clock drawing is severely abnormal, 1 point if one or both of the words are recalled, and the clock drawing is normal, or 2 points if both words are recalled and the clock drawing is normal.
06
Step 6: Interpret the score as follows: 0-2 points indicate cognitive impairment, and further evaluation is needed, while 3-5 points suggest normal cognitive function.

Who needs mini-cog instructions for administration?

01
Healthcare professionals who assess cognitive function in patients.
02
Researchers conducting cognitive studies.
03
Clinicians evaluating elderly individuals for cognitive impairment or dementia.
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The Mini-Cog is a brief cognitive assessment tool used to screen for cognitive impairment and dementia. It typically consists of a three-item recall task and a clock drawing test.
Healthcare professionals, particularly those in geriatrics or primary care, are generally required to utilize and file Mini-Cog assessments for patients who are suspected of having cognitive impairments.
To fill out the Mini-Cog instructions, first explain the tasks to the patient. Administer the three-word recall and clock drawing tasks, then score the results according to the established guidelines and document the scores in the patient's record.
The purpose of Mini-Cog instructions is to provide a standardized method for assessing cognitive function in patients, allowing for early detection of cognitive impairments or dementia.
The information that must be reported includes the patient's score on the recall task, the quality of the clock drawing, and any observations relevant to the patient's cognitive function.
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