Normal Abnormal Data to be filled in by site Integumentary (skin and/or breast) Not examined Normal Musculoskeletal (separate from Abnormal Data to be filled in by site ALS exam) Not examined Normal Neurological (separate from ALS Abnormal Data to be filled in by site exam) Not examined Normal Abnormal Data to be filled in by site Psychiatric Not examined Normal Abnormal Data to be filled in by site Respiratory Not examined Hand preference: (Hand participant/subject uses predominantly, not necessarily hand he/she writes with exclusively) Left hand Right hand Both hands Unknown *Element classified as Core
Integumentary (skin and/or breast) Normal Abnormal Not examined Data to be filled in by site Musculoskeletal (separate from ALS exam) Normal Abnormal Not examined Data to be filled in by site Neurological (separate from ALS exam) Normal Abnormal Not examined Data to be filled in by site Psychiatric Normal Abnormal Not examined Data to be filled in by site Respiratory Normal Abnormal Not examined Data to be filled in by site Hand preference: (Hand participant/subject uses predominantly, not necessarily hand he/she writes with exclusively) Left hand Right hand Both hands Unknown *Element classified as Core
F0960_Physical_Examination.docx