| GCS Sample Score Sheet | |||||
Best Eye Response (4 possible points)
|
|||||
Best Verbal Response (5 possible points)
|
|||||
Best Motor Response (6 possible points)
|
|||||
|
Assessment 1 | Assessment 2 | Assessment 3 | Assessment 4 | Assessment 5 |
Assessment by: Time: |
Assessment by: Time: |
Assessment by: Time: |
Assessment by: Time: |
Assessment by: Time: |
|
| Best eye response (4) | 1 2 3 4 |
1 2 3 4 |
1 2 3 4 |
1 2 3 4 |
1 2 3 4 |
| Best verbal response (5) | 1 2 3 4 5 |
1 2 3 4 5 |
1 2 3 4 5 |
1 2 3 4 5 |
1 2 3 4 5 |
| Best motor response (6) | 1 2 3 4 5 6 |
1 2 3 4 5 6 |
1 2 3 4 5 6 |
1 2 3 4 5 6 |
1 2 3 4 5 6 |
| Total: | |||||
Click Print to print this page.
Note: If you are using Internet Explorer on a Macintosh, you'll need to click File, then Print in the top toolbar.
