These forms are designed to be printed onto blank medical record pages. Other clinics, doctors, and physiotherapists are free to use these forms, however you should acknowledge authorship by the Falls and Balance Clinic – Kingston Centre, and any other authors.
It is often difficult to take and record a falls history. This form has been developed to help direct additional questions as needed and to record information. It is based on a Falls patient questionnaire devised by Eastern Health Falls and Balance Clinic which we have adapted.
This form was developed as we decided a home visit where a falls history is taken (Falls history form), a medication review, cognitive, visual, and safety in the home assessments would streamline and direct a clinic assessment.
This form was developed to record the examination swiftly and then direct diagnosis, investigation, and management.
This tool is used because depression effects gait parameters and even low scores on the GDS are predictive of falls. This form was developed by Dr. Stephanie Ward, geriatrician at Kingston Centre.
This document was developed to streamline writing care plans to the patient following a clinic visit. These phrases can be put onto the computer such that they will auto-populate the care plan.
We have noted significant issues of compliance by the patient and the GP with our recommendations so this is plan is written is a specific fashion. There should be up to 3-4 problems, maximum of five as not to overwhelm the patients. There can be as many recommendations as necessary. A copy of this is sent to the GP as well as the patient.
This letter is designed to written from a physiotherapist to a GP to prompt the GPs to address a falls issue that the physio has identified. The letter was developed in conjunction with the Aged Care Steering Committee of the Dandenong Casey division of General Practice to be acceptable to GPs.
To use the letter you need to delete the sections that are not relevant to the patient.