Examples of self assessments
[PDF File]Scoring Instructions for NICHQ Vanderbilt Assessment Scales
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Scoring Instructions for NICHQ Vanderbilt Assessment Scales ASSESSMENT AND DIAGNOSIS Page 2 of 2 The recommendations in this publication do not indicate an exclusive course of treatment or serve as a standard of medical care.Variations, taking into account individual circumstances, may be appropriate.
[PDF File]Form 4506-T (Rev. 6-2019)
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assessments, and adjustments made by you or the IRS after the return was filed. Return information is limited to items such as tax liability and estimated tax payments. Account transcripts are available for most returns. Most requests will be processed within 10 business days . c Record of Account,
[PDF File]Oswestry Low Back Disability Questionnaire - Rehabilitation
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The Oswestry Disability Index (also known as the Oswestry Low Back Pain Disability Questionnaire) is an ... self-care . I do not get dressed, I wash with difficulty and stay in bed : Section 3 – Lifting ... Oswestry Low Back Disability Questionnaire . Section 5 – Sitting .
[PDF File]ASSESSMENT Timed Up & Go (TUG)
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Steadying self on walls Shuffling En bloc turning Not using assistive device properly These changes may signify neurological problems that require further evaluation. Timed Up & Go (TUG) When I say “Go,” I want you to: 1. Stand up from the chair. 2. Walk to the line on the floor at your normal pace. 3. Turn. 4.
[PDF File]TINETTI BALANCE ASSESSMENT TOOL
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TINETTI BALANCE ASSESSMENT TOOL GAIT SECTION Patient stands with therapist, walks across room (+/- aids), first at usual pace, then at rapid pace.
[PDF File]VAMC SLUMS Examination - Saint Louis University
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SH Tariq, N Tumosa, JT Chibnall, HM Perry III, and JE Morley. The Saint Louis University Mental Status (SLUMS) Examination for Detecting Mild Cognitive Impairment and Dementia is more sensitive than the Mini-Mental Status Examination (MMSE) - A pilot study. J am Geriatri Psych ( in press). 2 3 Questions about this assessment tool? E-mail aging ...
[PDF File]Form N-648, Medical Certification for Disability Exceptions
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Form N-648, Medical Certification for Disability Exceptions. ALL parts of this form, except the "APPLICANT ATTESTATION" and "INTERPRETER'S CERTIFICATION" must be certified by a licensed medical professional as provided in the instructions for Form N-648. Before certifying this form, the medical professional must
[PDF File]International Prostate Symptom Score (I-PSS)
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About the I-PSS The International Prostate Symptom Score (I-PSS) is based on the answers to seven questions concerning urinary symptoms and one question concerning quality of life.
[PDF File]Form W-9 (Rev. October 2018)
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amount reportable on an information return. Examples of information returns include, but are not limited to, the following. • Form 1099-INT (interest earned or paid) • Form 1099-DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds)
[PDF File]The Mood Disorder Questionnaire (MDQ) - Overview
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The Mood Disorder Questionnaire (MDQ) - Overview The Mood Disorder Questionnaire (MDQ) was developed by a team of psychiatrists, researchers and consumer advocates to address the need for timely and accurate evaluation of bipolar disorder. Clinical Utility n The MDQ is a brief self-report instrument that takes about 5 minutes to complete.
[PDF File]Patient Health Questionnaire (PHQ-9)
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Note: Since the questionnaire relies on patient self-report, all responses should be verified by the clinician, and a definitive diagnosis is made on clinical grounds taking into account how well the patient understood the questionnaire, as well as other relevant information from the patient.
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