Right Side/Left Side Data Table

Print this page for each subject you test. Place a check mark in the box for the hand, foot, eye or ear that your subject uses in each test.

Part of BodyTestRight SideLeft Side
Write name
Use scissors
Throw ball
Drink from cup
Fork to Mouth
Kick ball
Step up stair
Step on object
Look in tube
Sight a finger
Look through hole
Listen to whisper
Listen to box
Listen through wall


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