Run Montreal Cognitive Assessment (MoCA) Cognitive Screening — Free

Assessment Details and Administrator Verification

Administrator certification verified critical (required)

Confirm the administrator is trained and certified/authorized to administer the MoCA.

Yes No N/A

Assessment date and time recorded

Document when the MoCA was administered.

Assessment setting documented

Record the location or setting where the assessment was completed.

Reason for screening documented

Briefly state the clinical or operational reason for the MoCA screening.

Participant consent or assent confirmed critical (required)

Confirm the participant agreed to proceed with the screening per local policy.

Yes No N/A

Language or interpreter needs noted

Document the language used for administration and any interpreter support or accommodations.

Administration Conditions

Testing environment free from distraction critical (required)

Confirm the participant was assessed in a quiet environment with minimal interruptions.

Yes No N/A

Corrective lenses or hearing aids available if normally used

Confirm the participant had access to usual visual or hearing aids during testing, if applicable.

Yes No N/A

Participant alert and able to participate critical (required)

Confirm the participant was sufficiently alert and cooperative for valid administration.

Yes No N/A

Any testing interruptions documented

Record any interruptions, fatigue, pain, or other factors that may have affected performance.

Standard MoCA instructions followed critical (required)

Confirm the assessment was administered according to the standardized instructions.

Yes No N/A

MoCA Domain Scoring

Visuospatial / executive function score

Enter the score for visuospatial and executive function tasks.

Note (optional)

Naming score

Enter the score for naming tasks.

Attention score

Enter the score for attention tasks.

Language score

Enter the score for language tasks.

Abstraction score

Enter the score for abstraction tasks.

Delayed recall score

Enter the score for delayed recall tasks.

Orientation score

Enter the score for orientation items.

Total Score and Interpretation

Total MoCA score critical (required)

Enter the total MoCA score out of 30.

Note (optional)

Score interpretation

Select the interpretation based on the total score and clinical context.

Education adjustment applied

Indicate whether the standard education adjustment was applied, if applicable.

Yes No N/A

Follow-up recommendation documented

Document any recommended next steps, referral, or repeat assessment plan.

Results communicated per policy critical (required)

Confirm results were communicated according to organizational policy and scope of practice.

Yes No N/A

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Run: Montreal Cognitive Assessment (MoCA) Cognitive Screening

Assessment Details and Administrator Verification

Administration Conditions

MoCA Domain Scoring

Total Score and Interpretation

Get your results