Capacity Screening – CUAR Date of Screening: {formdate: MM/DD/YYYY; name=Screening Date}
C – Communicate a Choice: The patient can clearly and consistently state a treatment decision. [{formmenu: Yes; No; name=Communicate a Choice}]
U – Understand: The patient understands the diagnosis/clinical situation, proposed intervention, risks vs benefits, and possible alternatives (including no treatment). [{formmenu: Yes; No; name=Understand}]
A – Appreciate: The patient appreciates how the decision affects their health and recognizes potential consequences of accepting or refusing treatment options. [{formmenu: Yes; No; name=Appreciate}]
R – Reason: The patient is able to compare options and provide a logical rationale for choice. Reasoning is goal directed and reality based. [{formmenu: Yes; No; name=Reason}]
Screening Result: {formmenu: Positive screening - there is evidence that patient can make this decision; Negative screening - there is evidence that patient CANNOT make this decision; Inconclusive - there is partial evidence and more comprehensive evaluation is needed; Fluctuating - screening with inconsistencies noted likely due to reversible factors, reassessment recommended at future visit; name=Screening Result}