Falls Efficacy Scale Header Image

Falls Efficacy Scale

Answer the following questions by selecting the appropriate response. A total score will be calculated for you. 


0          1          2          3          4          5          6          7          8          9          10

           Very Confident                                                                                             Not at all Confident 

Name
Take a bath or shower*
Reach into cabinets or closets*
Walk around the house*
Prepare meals not requiring carrying heavy or hot objects*
Get in and out of bed*
Answer the door or telephone*
Get in and out of a chair*
Getting dressed and undressed*
Personal grooming (i.e. washing your face)*
Getting on and off of the toilet*
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