Appendix 2: Norton Risk Assessment Scale

Introduction

PHYSICAL CONDITION

MENTAL CONDITION

ACTIVITY

MOBILITY

INCONTINENT

TOTAL SCORE

Name

Date

Good 4

Fair 3

Poor 2

V. Bad 1

Alert 4

Apathetic 3

Confused 2

Stupor 1

Ambulant 4

Walk/help 3

Chairbound 2

Bed 1

Full 4

SI. limited 3

V. limited 2

Immobile 1

Not 4

Occasional 3

Usually/Urine 2

Doubly 1

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