Fall Risk Screening Toolkit

(Former known as the Balance & Gait Screening Toolkit)

1. Balance & Gait Screening Checklist (1 page)
2. Flyer Template – FPAW 2013 (requires editing; 1 page)
   1. Flyer Template, Spanish – FPAW 2013 (requires editing; 1 page)
3. FPAW 2013 Press Release Template (requires editing; 1 page)
4. Community Letter Template – FPAW (requires editing; 1 page)
5. Suggested Target Audiences for Outreach (1 page)
6. Volunteer Sign-Up Sheet (1 page)
7. Wayfinding Signage – General (15 pages)
8. Wayfinding Signage – FPAW (15 pages)
9. Suggestions for Displaying Posters (2 pages)
10. Stay Independent Self-Assessment (2 pages; from STEADI Toolkit)
11. 8-Foot Up-and-Go Instructions (1 page) AND Timed Up & Go (TUG) Test (1 page; from STEADI Toolkit)
12. Screening Results Form (1 page)
13. Health Activity Questionnaire (1 page)
14. Participant Media Release Form (1 page)
15. Balance & Gait Screening Attendee Evaluation Form (1 page)
    1. Balance & Gait Screening Attendee Evaluation Form, Spanish (1 page)
16. Tracking & Reporting Form (2 pages)

Last Updated: September 2013

Posted in: Fall Risk Screening Toolkit