NM301041 (Rev. 09/27/16) Worksheet Only – Not a Medical Record Document
UW Health uwhealth.org
(University of Wisconsin Hospitals and Clinics Authority)
HENDRICH II FALL RISK MODEL™
Get Up & Go Test
Able to rise in a single movement – No loss of balance with steps
Pushes up, successful in one attempt
Multiple attempts, but successful
Unable to risewithout assistance during test (OR if a medical order
A Score of 5 or Greater = High Risk Total Score
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