Customizable 'Staying Independent Checklist'
NEW Customize this Staying Independent Checklist by adding your organization’s logo and website details or leave it as is.
For a copy of the template without the Fall Prevention Month logo, contact Michelle Dueckman (firstname.lastname@example.org).
The Staying Independent Checklist is a self-screening tool for older adults to find out if they are at risk of falling. Older adults are encouraged to complete the Checklist and to follow-up with their healthcare provider as needed.