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Instructions for R-SRAFVP
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SRA Instructions
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Health Management and Personal Grooming
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1. Medication set up
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1a.
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2. Taking Medication
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2a
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3. Obtaining supplies/food
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3a
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Health Managment Comments
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4. Dressing
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4a
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5. Hair care
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5a
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6. Nail care
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5a
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7. Oral care
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7a.
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Personal Care Comments
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Meal Preparation and Clothing Care
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8. Chop/slice/peel
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8a
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9. Pour/measure ingredients
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9a
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10. Meal Preparation - microwave
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10a
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11. Meal Preparation - stove burners
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11a
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12. Meal Preparation - oven
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12a
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13. Laundering
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13a
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Meal Preparation and Clothing Care Comments
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Financial Management
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14. Manage records
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14a
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15. Accurately read bills/financial statements
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15a
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16. Write check or money order
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16a
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Financial Management Comments
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Using the Telephone
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17. Physically operate telephone
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17a
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18. Retrieve telephone numbers
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18a
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Telephone Comments
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Reading
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19. TV Guide on TV
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19a
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20. Books
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20a
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21. Labels/instructions
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21a
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22. Credit/debit cards
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22a
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Reading Comments
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Writing
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23. Legible personal list/short note
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23a
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24. Legibly address envelope
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24a
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25. Legible signature
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25a
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Writing Comments
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Functional Mobility
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26. Ascend/descend stairs
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26a
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27. Adjusts to changes in walking surfaces
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27a
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28. Avoid collisions/tripping
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28a
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29. Locates and reads signs
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29a
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Mobility Comments
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Personal Preference Activities
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30. Shaving
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30a
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31. Leisure activities
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31a
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32. Operate leisure devices
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32a
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33. Read Timepiece
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33a
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Leisure Comments
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Eval
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G Code List
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Eval Total
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Eval % Impairment
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Eval G Code
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Goal G Code
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Prognosis
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Discharge
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Calculation for impairment percentage
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Discharge Total
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Discharge % Impairment
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Discharge G Code
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