Section Questions Max Points Patients Score
1) Orientation a) Can you tell me today's (date)/(month)/(year)?
Which day is it today?
Can you tell me which (season) it is?		 5  
b) What town/city are we in?
What is the (county)! (country)?
What (building) are we in and on what (floor)		 5  
2) Registration I should like to test your memory.
(name three common objects: "ball, car, man") Can you repeat the words I said?
(1 point per word)
(repeat up to 6 trials until all three are remembered)
(record number of trials here: 		3  
3) Attention and Calculation a) From 100 keep subtracting 7 and give each answer. Stop after 5 answers. (93_86_79_72_65) Alternatively
b) Spell the word "World" backwards. (D_L_R_O_W)		 5  
4) Recall What were the three words I asked you to say earlier?

(skip this test if all of these objects were not remembered during the registration test)

 3  
5) Language Naming Repeating Name the following objects (show a watch) and
(show a pencil) 		2  
Repeat the following: "no ifs, ands or buts" 1  
6) Reading (show card or write: "Close your Eyes") Read this sentence and do what it says. 1  
Writing Now can you write a short sentence for me? 1  
7) Three stage command (present paper)
Take this paper in you left (or right) hand, fold it
in half, and place it on the floor.		 3  
8) Construction Will you copy this drawing please?

 

 

 1  
Total score 30