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Interest Checklist (Uk) : Category Activity Degree of Interest Participation?

This document contains an interest checklist for an occupational therapy patient. The checklist includes 9 categories of activities - health & fitness, sports, creative, productivity, leisure, social, outdoor pursuits, out and about/entertainment, and educational. For each activity listed, the patient rates their degree of interest on a scale from strong to none, and notes if they have participated in the past, present, or have future interest. The occupational therapist will use this checklist to identify the patient's strong interests and create an action plan to encourage participation in selected activities.

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Isa Espallargas
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3K views3 pages

Interest Checklist (Uk) : Category Activity Degree of Interest Participation?

This document contains an interest checklist for an occupational therapy patient. The checklist includes 9 categories of activities - health & fitness, sports, creative, productivity, leisure, social, outdoor pursuits, out and about/entertainment, and educational. For each activity listed, the patient rates their degree of interest on a scale from strong to none, and notes if they have participated in the past, present, or have future interest. The occupational therapist will use this checklist to identify the patient's strong interests and create an action plan to encourage participation in selected activities.

Uploaded by

Isa Espallargas
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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South West London and St.

George’s NHS Trust – Occupational Therapy Service

Name:………………………………………… Date of Birth:………………………..

INTEREST CHECKLIST (UK)


Category Activity Degree of Interest Participation?
Strong Some None Past Present Future
1 Health & Aerobics / Gym
Fitness
Cycling
Running / Jogging
Roller blading / Ice Skating
Swimming
Yoga / Tai Chi…..
Other Health and
fitness
2 Sports Athletics
Basketball / Netball
Bowling
Cricket / Baseball / Rounders
Darts
Football / Rugby / Hockey
Golf
Martial Arts / Boxing / Fencing
Pool / Snooker
Spectator Sports
Table Tennis
Tennis / Squash / Badminton
Other Sports:

3. Creative Amateur Dramatics


Crafts / Needlework
Fashion: incl Clothes / Hair / Cosmetics
Making music – incl. instrument, DJ’ing….
Model Building
Painting / Drawing (Art)
Photography
Pottery
Singing
Writing: letters / poems / stories
Woodworking – incl. Picture Framing,
Furniture Restoration
Other Creative:

4. Productivity - at Car Repair


home
Cooking / Baking
Gardening – incl Indoor Plants
Mending / DIY
Pet ownership
Other Productivity at
home
Strong Some No Past Now Future
5. Leisure- at Board games – chess, scrabble etc.
home
Collecting
Computing – games / pc / internet
Listening to music
Playing cards
Puzzles / Crosswords
Radio
Reading
Television / Video
Other Leisure at
home
6. Social: Clubs: Social / Nightclubs
Eating out
Faith-related activities
Inviting / visiting friends / family
Pubs / bars
Voluntary work
Other social:
7. Outdoor Bird watching / Wildlife
Pursuits
Camping
Climbing
Ecology / Conservation
Fishing
Horse riding
Walking
Water Sports incl. canoeing / rowing
Other outdoor
pursuits
8. Out and About / Bingo
Entertainment
Cinema
Concerts /Theatre
Dancing
Driving
Jumble/car boot sales/charity shops
Museums / art galleries
Places of interest / day trips
Shopping (incl. Markets)
Traveling / Holidays
Other out and about:

9. Educational Antiques
Courses / adult education
Foreign Languages
History
Politics / Philosophy
Science
Speeches / Lectures
Other educational

Occupational Therapist………………………………… Signed……………………….. Date…………………


South West London and St.George’s NHS Trust – Occupational Therapy Service

INTEREST SUMMARY
Name:……………………………………… Date of Birth……………………..

Strong Interests

ACTION PLAN

SHORTLIST ACTION PLAN

Occupational Therapist………………………………… Signed…………………….. Date…………………

V6.1. David Heasman / Paul Brewer. 2008

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