Today's date:                Time:

Patient's Initials:                    Patient Number:  

Study Number:                       Rater's Initials:

SIMPSON-ANGUS SCALE

1. Gait                                              0      1      2      3       4

2. Arm dropping                               0      1      2      3       4

3. Shoulder shaking                           0      1      2      3       4

4. Elbow rigidity                                0      1      2      3       4

5. Fixation of position

        or wrist rigidity                          0      1      2      3       4

6. Leg pendulousness                        0      1      2      3       4

7. Head dropping                              0      1      2      3       4

8. Glabella tap                                   0      1      2      3       4

9. Tremor                                         0      1      2      3       4

10. Salivation                                    0      1      2      3       4