, Kempt Clean
Unkempt Dirty
Confirmed orientation
To Person (1/3 point) To Place (1/3 point)
Oriented to person Oriented to place
Not oriented to person Not oriented to place
To Time (1/3 point)
Oriented to time
Not oriented to time
Assessed speech
Rate (1/3 point) Volume (1/3 point)
Demonstrates appropriate or expected rate of speech Demonstrates appropriate or expected spe
Excessively slow or rapid rate of speech Excessively loud or soft speech volume
Articulation (1/3 point)
No appreciable abnormalities with articulation
Abnormalities with articulation, slurring, or stutters
Assessed mood and affect
Mood (1/2 point) Affect (1/2 point)
Stable mood with little or no fluctuation throughout the interview Full or balanced (normal)
Frequent and appreciable mood changes throughout the interview Expansive affect (excessively cheerful affe
contagious laughter or smiling)
Blunted or flat affect (little to no variation o
conversation topic)
Inspected head and face
Skull Symmetry (1/3 point) Facial Feature Symmetry (1/3 point)
Symmetric Symmetric
Asymmetric Asymmetric
Appearance (1/3 point)
No visible abnormal findings
Rash
Papules, pustules, or comedones
Freckles, moles, or birth mark
Excessive hair growth
Evidence of skin trauma (scar, laceration, or bruising)
Inspected neck
Symmetry (1/3 point) Appearance (1/3 point)
Symmetric No visible abnormal findings
Asymmetric Swelling
Visible pulsation
Visible mass
,