When you are prone to falling, your home can either support you or become a reason
for your falls. The following is a list of common things that make a difference in a
Look around you and answer the questions truthfully about how well your home is
helping you avoid falling. Then think about how you can change things to make it less
likely that you will fall. Bring this form with you for your evaluation.
Please choose the best response to each of the questions below: