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Stroke Risk Assessment Form - thompsonhealthcom

Stroke Risk Assessment Form - thompsonhealthcom 2026

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4.8 out of 5

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The document is a Stroke Risk Assessment Form designed to evaluate an individual's risk factors for stroke. It collects personal information such as age, height, weight, race, and medical history, including family history of strokes or heart conditions. The form includes sections for measuring vital signs like blood pressure and cholesterol levels, along with a classification system for these measurements. An action plan is provided for follow-up steps based on the assessment results, emphasizing the importance of consulting a physician and lifestyle modifications. Additionally, it outlines emergency symptoms that require immediate medical attention.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your age, height, and weight in the designated fields. This information is crucial for assessing your stroke risk.
Fill in your state and race/ethnicity. These details help provide a comprehensive overview of your background.
In the 'Uncontrollable Risk Factors' section, check all applicable boxes related to your personal and family medical history, including previous strokes or heart attacks.
Complete the medical history section by checking any relevant conditions that apply to you or your blood relatives.
Record your blood pressure, pulse rate, cholesterol levels, and glucose level in the assessments section. Ensure accuracy for effective evaluation.
Review the results classification table to understand where you stand regarding blood pressure and cholesterol levels.
Finally, sign and date the form at the bottom to confirm that all information provided is accurate.

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Versions	Form popularity	Fillable & printable
2022	4.7 Satisfied (26 Votes)
2003	4.8 Satisfied (49 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Is there a test to determine stroke risk?

C-reactive protein (CRP) test is a quick, finger- blood test to check for high C-reactive proteins, which can be a warning sign for stroke.

How to do a stroke assessment?

A test called a carotid ultrasound may also help predict an impending stroke. A carotid ultrasound is a noninvasive imaging test that can detect the buildup of plaque in the carotid arteries in your neck. These arteries supply blood to your brain.

What is the most common diagnostic test for a stroke?

There are several imaging tests used to diagnose stroke. Computed tomography (CT) uses X-rays to take clear, detailed pictures of your brain. It is often done right after a suspected stroke. A brain CT scan can show whether there is bleeding in the brain or damage to the brain cells from a stroke.

What is better for stroke, MRI or CT scan?

Despite being more time-consuming and less available, brain magnetic resonance imaging (MRI) offers several advantages over CT,7 including higher sensitivity in detecting early ischemic stroke, more precise localization of the ischemic lesion, more accurate detection of stroke mimics, likely better quantification of

What is the test for stroke risk assessment?

A score of 0 indicates low risk, a score of 1 indicates low-to-medium risk and a score of 2 or more indicates moderate-to-high risk. It also notes that aspirin monotherapy should not be offered solely for stroke prevention in these people.

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What is the tool to assess stroke risk?

Use the Face Arm Speech Test (FAST) validated tool for rapid assessment. Suspect stroke if one or more of the following are present: new facial weakness (asymmetry such as the mouth or eye drooping), arm or leg weakness, or speech disturbance (such as slurring or difficulty in finding names for commonplace objects).

Stroke Risk Assessment Form - thompsonhealthcom 2026

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