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Bender Gestalt Test

Rationale

Why the test was administered (reference)

Identifying Data

Name Initials: X.Y.Z

Age:

Gender Class:

Institute/place:

Behavioral Observation (if in Special education setting)

Appearance, mood, learning readiness Skills, Speech, Rapport building, Paper and pencil
holding, pencil pressure, time taken to complete each/all designs.

Behavioral Observation (if in Adult Psychiatric setting)

Appearance, mood, mental status examination (brief)

Quantitative Interpretation

Legend

Raw Score Z-Score

Qualitative Interpretation

Gestalt was present/absent, types of errors (if gestalt present), what do they indicate? Link
observation and interpretation

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