The following quiz will help you identify your fall risk. To complete the quiz, indicate if you are "Completely Confident", "Fairly Confident", or "Not Confident At All" while performing the following tasks.

If you have any items marked "Not Confident At All" or more than three items marked "Fairly Confident", you would likely benefit from intervention to decrease your fall risk. We recommend that you share this fall-risk assessment with your physician and discuss possible treatment options.

Activity

Getting dressed and Undressed
Preparing a simple meal
Taking a bath or shower
Getting in/out of a chair
Getting in/out of bed
Answering the door or telephone
Walking around inside home
Reaching into cupboards or closets
Light Housekeeping
Simple shopping
Walking across the street
Light gardening or hanging out wash
Using front or rear steps at home