Community Integration Questionnaire - Stroke …

Stroke Specific Quality of Life Scale - Stroke Center

Stroke Speci!c Quality of Life Scale (SS-QOL) Scoring: each item shall be scored with the following key Total help - Couldn't do it at all - Strongly agree 1

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Cincinnati Prehospital Stroke Scale - Stroke Center

CINCINNATI PREHOSPITAL STROKE SCALE Facial Droop Normal: Both sides of face move equally Abnormal: One side of face does not move at all Arm Drift

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Berg Balance Scale - Stroke Center

BERG Patient Name: _____ BALANCE Rater Name: _____ SCALE Date: _____ Balance Item Score (0-4) 1. Sitting unsupported _____

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Recovering After a Stroke: A Patient and Family Guide

Recovering After a Stroke: A Patient and Family Guide 2 Recovering From Stroke The process of recovering from a stroke usually includes treatment, spontaneous recovery,

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MODIFIED Patient Name RANKIN Rater Name: Date

Provided by the Internet Stroke Center — www.strokecenter.org MODIFIED Patient Name: _____ RANKIN Rater Name: _____ SCALE (MRS) Date: _____

ACTION Patient Name Date - Internet Stroke Center

ACTION Patient Name: _____ RESEARCH Rater Name: _____ ARM TEST Date: _____ Instructions There are four subtests: Grasp, Grip, Pinch, Gross Movement.

FUNCTIONAL EVALUATION: THE BARTHEL INDEX

Mahoney FI, Barthel D. “Functional evaluation: The Barthel Index.” Maryland State Medical Journal 1965;14:56-61. Used with permission. REHABILITATION NOTES

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NIH Stroke Scale - Stroke Center

Administer stroke scale items in the order listed. Record performance in each category after each subscale exam. Do not go back and change scores.

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Instructions Scale Definition Score - Stroke Center

Patient Identification. ___ ___-___ ___ ___-___ ___ ___ Pt. Date of Birth ___ ___/___ ___/___ ___ Hospital _____(___ ___-___ ___) Date of Exam ___ ___/___ ___/___ ___

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INSTRUMENTAL ACTIVITIES OF DAILY LIVING …

INSTRUMENTAL ACTIVITIES OF DAILY LIVING SCALE (IADL) M.P. Lawton & E.M. Brody Rationale This tool is valuable for evaluating patients with early-stage disease, both to assess the level of disease and to determine the

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IT – Application Controls Questionnaire - ASU

IT – Application Controls Questionnaire Internal Control Questionnaire Question Yes No N/A Remarks A1.a. MULTIPLE USER PROCESSING — INPUT CONTROLS

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IT - General Controls Questionnaire - ASU

IT - General Controls Questionnaire Internal Control Questionnaire Question Yes No N/A Remarks G1. ACCESS CONTROLS Access controls are comprised of those policies and procedures that

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A Brief Guide to Questionnaire Development

Introduction A Brief Guide to Questionnaire Development Robert B. Frary Office of Measurement and Research Service Virginia Polytechnic Institute and State University

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Known Importer Questionnaire - The National …

1 8690396_1 03/07/2013 1:22 pm DRAFT Known Importer Questionnaire This document is intended to provide the Broker with information needed to prepare the

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Measuring Implementation in Schools: THE …

Measuring Implementation in Schools: THE STAGES OF CONCERN QUESTIONNAIRE Archie A. George, PhD Gene E. Hall, PhD Suzanne M. …

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Performance Evaluation Questionnaire Template …

Performance Evaluation Questionnaire Template for the Directors of Investment Trusts Prepared by Trust Associates Limited in accordance with the Performance

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Dissolution Questionnaire - michigan.gov

Dissolution Questionnaire . All Michigan nonprofit organizations must obtain a letter from the Attorney General in order to file a Certificate of Dissolution with the Department of Licensing and Regulatory Affairs (LARA),

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Uniform Certificate of Authority Application …

If yes, provide the details in writing and attach to the Questionnaire . 8. A. Has the Applicant Company's certificate of authority to do business in …

  Questionnaire