.|.|The Six-Item Blessed Orientation-Memory-Concentration Test (BOMC)||Date Given: <.Date_Given.>|Clinician: <.Staff_Ordered_By.>|Location: <.Location.>||Veteran: <.Patient_Name_Last_First.>|SSN:
<.Patient_SSN.>|DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)|Gender: <.Patient_Gender.>|| BOMC weighted error score: <-Weighted error score-> ||This score has a range of 0 to 28.|A score
greater than 10 is considered abnormal and warrants further
evaluation.||Questions
and Answers||1. What year is it now?| <*Answer_4173*>|1a.
Patient's response:| <*Answer_4179*>|2. What month is it now?| <*Answer_4174*>|2a. Patient's response:| <*Answer_4180*>|3. About what time is it? (within one hour)| <*Answer_4175*>|3a.
Patient's response:| <*Answer_4181*>|4. Count backwards from 20 to 1.| <*Answer_4176*>|4a. Patient's response:| <*Answer_4182*>|5. Say the months in reverse order.| <*Answer_4177*>|5a.
Patient's response:| <*Answer_4183*>|6. Repeat the memory phrase.| <*Answer_4178*>|6a. Patient's response:| <*Answer_4184*>||Information contained in this note is based on a self report
assessment and is not sufficient to use alone for diagnostic purposes. Assessment results should be verified for accuracy and used in conjunction with other diagnostic activities. $~
|
