This fall risk assessment template is used to evaluate a patient's probability of falling. It includes fields to record a patient's fall history, current medication, and medical test results (vision, peripheral sensation, and mobility). Record the patient's fall risk rating depending on the number of accumulated risk factors. If a patient gets 1-2 risk factors patient has a Low risk probability of falling, a Medium risk for 3-5 risk factors and High risk for 6 risk factors and above.
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Templateby SafetyCultureMorse Fall Risk Assessment
This Morse Fall Risk Assessment Tool derived from the Morse Fall Scale (MFS) was converted using SafetyCulture and is used to help assess a patient's likelihood of falling. Perform this Morse Fall Risk Assessment by answering 6 essential questions. This template includes a risk rating table which will help you assign a fall risk rating (High, Medium, Low) based on the responses to the 6 essential questions.
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