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Information on our New Forms!


Cognitive Assessment Tool Guide Cognitive Assessment Tool Guide (pad of 50 sheets)

This tool is designed to help identify a person’s cognitive status when using the Allen Cognitive Assessment Battery or the Adapted FAST. The clinician will be guided through how to extract key observations from activity performance in order to identify a dementia stage/Allen level. Scoring is simple as the client may be functioning at the highest stage in which the majority of boxes (representing a functional ability observed) were checked. Once this worksheet is completed, the clinician should verify the results with the Adapted FAST and/or the Allen Battery (such as placemat or leather lacing) as needed.

Item #: 1021 Cost: $9.50 plus S&H




Therapy Screening Form Therapy Screening Form (2 part carbonless-pack of 50)

This form aids the therapist when screening to pick up new clients on their caseload. Allen training elements and current reimbursement guidelines are incorporated in this screening tool.

Item #: 6281 Cost: $15.00 plus S&H










Nursing Screening Form Nursing Screening Form (2 part carbonless-pack of 50)

This form helps nursing care partners to identify a resident who could benefit from therapy services. Often nursing does not understand all of the ways in which therapy can serve the person with dementia and therefore this tool is designed to bridge that knowledge gap to increase referrals.

Item #: 1229 Cost: $15.00 plus S&H










Maintenance Program Forms Maintenance Program Forms
(3 part carbonless-pack of 50)

Never before has designing a maintenance program been so quick and easy. This form has been designed to enable a therapist to easily create a quality maintenance program to share with team members and/or families.
The form is pre-loaded with common caregiver approaches and environmental recommendations to match a specific Allen level. Also included on the back of the form is a quick reference for converting the Allen level into maximum level of function and cueing type needed. Some customization is allowed.

This form is available for 4 different Allen levels! See below for item numbers.

Level 1 is Item #: 3061 Cost: $25.00 plus S&H
Level 2 is Item #: 3062 Cost: $25.00 plus S&H
Level 3 is Item #: 3063 Cost: $25.00 plus S&H
Level 4 is Item #: 3064 Cost: $25.00 plus S&H







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