Print Handout
Date:
Name:
DOB:
Presentations:
1
2
3
4
5
6
Alternates: pencil/bicycle/shoe; orange/car/dog. Present up to 6x to complete.
D/93
L/86
R/79
O/72
W/65
Or serial 7’s.
Previous score:
Previous date:
Score 0-14 suggests
Dementia
Score 15-23 suggests
Cognitive Loss/depression
Score 24-30 suggests
Normal cognitive
Subject:
STOPWATCH
