Untitled Document

Flinn Performance Screening Tool Form Preview

The FPST covers many areas of function including self-care, home/outside, leisure,
and work skills. A small sampling of self-care skills is showcased in this demo.
(Contains 38 pages of 382 total pages)

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*Name
*Email
Phone
Comments
As a demonstration, you will receive an email that will be a duplicate of the information that a practioner would receive when the patient submits their information. Note, The above fields can be adjusted according to the practioner's needs or preferences.
Select Important and Difficult Tasks

Personal Hygiene
A1 Shave Face	A8 Use Rollers	A15 Use Aerosol Spray	B3 Brush Teeth
A2 Apply Makeup	A9 Style/Braid Hair	A16 Shave Legs	B4 Brush Dentures
A3 Wash Hair	A10 Trim Nails	A17 Pluck Eyebrows	B5 Use Tooth Powder
A4 Blow Dry Hair	A11 Care for Fingernail	A18 Use Lotion	B6 Use Dental Floss
A5 Comb Hair	A12 Care for Toenails	A19 Clean Ears	B7 Use Water Pic
A6 Brush Hair	A13 Apply Deodorant	B1 Turn Faucets	B8 Use Mouthwash
A7 Curl Hair	A14 Use Pump Spray	B2 Press Toothpaste
List Other Concerns:

As a demonstration, you will receive an email that will be a duplicate of the information that a practioner would receive when the patient submits their information.

Select Important and Difficult Tasks

As a demonstration, you will receive an email that will be a duplicate of the information
that a practioner would receive when the patient submits their information.