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zADULT Depression screen and Fall Risk Assessment

SUNIL LALLA, MD FCCP

 

Please answer all the questions below: All questions with * are required.

Fall Risk Assessment

 
 
 
 
 
 
 
 
 
 
 
 
Please Total Questions 1 - 12
 
 
 

PHQ 9 Depression screening

 

Over the last 2 weeks, how often have you been bothered by any of the following problems? (use to indicate your answer)

 
 
 
 
 
 
 
 
 
 
 
Please total questions 1 -10
* Required field