You are on page 1of 2

INTEREST CHECK LIST

Name: Age: Date:


Sex: Marital Status: Occupation:

likes Dislikes Engages Does Not


Engage

Manual
Sewing
Needlework
Building
Woodworking
Leatherwork
Painting
Knitting
Gardening
Home Repairs
Physical Sports
Soccer
Exercise
Athletics
Volleyball
Netball
Other:
ADLs
Mending
Ironing
Floor mopping
Home repairs
Driving
Dusting
Cooking
Shopping
Laundry
Decorating
Hairstyling
Bathing
Other:
Leisure:
Writing
draft
Reading
dancing
Other:

You might also like