Simple Self-Test Questionnaire
| Yes | No | |
|---|---|---|
| Have you had a fall or several falls? | ||
| Do you have a fear of falling? | ||
| Do you have poor vision or are you legally blind? | ||
| Are you on any medications that cause you to feel dizzy, unsteady on your feet, confused or drowsy? | ||
| Are you using a mobility aid such as a walking stick, walking frame or wheelchair? | ||
| Have you been in hospital within the last six months? | ||
| Do you have any chronic medical conditions? | ||
| Are you frail or low in weight? | ||
| Do any of these apply to anyone who lives with you? |
If you answered "yes" to one or more of the above questions, then you may benefit from Rehability's Home Safety Assessment. For more information, contact Rehability on (03) 9816 9777 or email us at coordinator@rehability.com.au