Falls Risk Screen (Romanian)

This is the Romanian page for Fall Risk Screening. Click below for other languages:

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What is your full name?


What is your date of birth?



Answer option for these questions: Yes or No


Right now, are you feeling weak, dizzy, or lightheaded?


Have you fallen in the past 3 months?


Do you need assistance to walk?


Do you need a cane?


Do you need crutches?


Do you need a walker?


Do you need a wheelchair?


Do you need a companion to help you?


Do you have a fear of falling?


Have you taken or will you take any medications for anxiety to help you with this exam today?