General Survey FormObjective: Conduct a General survey on a person of your choice. The purpose of this interaction isobservation only.1. Physical Appearance/Hygiene:a. General appearance:b. Genderc. Apparent aged. Ethnic groupe. Appears overall healthyf. Well-groomed or disheveled (Note the general color of skin and hygiene)2. Body Structure and Movement (Observe general stature):a. Height appropriate for apparent ageb. Appears well nourishedc. Weight suitable for the heightd. Position or posture (comfortable and relaxed)e. Obvious deformitiesf. Walks with easeg. Gait balanced and smoothh. Limitations to range of motioni. Involuntary movementsj. Using assistive devices3. Emotional/Mental Status and Behavior:Level of alertnessAppear well rested or tiredConverse appropriatelyBehavior appropriate for the situationDress suitable for the weather4. Document observations with detailed responses in a narrative format. For example, if aclient appears tired provide a description adequate for the reader to visualize the client,“Client is alert and appears tired, slumped in a chair with eyes half closed.”5. Describe two actual or potential risk factors for the client based on the assessmentfindings with description or reason for selection of them
