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Work Behavior
<br />Sporadic Work Performance
<br />Error ln Judgment
<br />Confusion (e.9., Difficulty ln Recalling lnstructions,
<br />Details)
<br />Difficulty ln Concentration
<br />Procrastinaiion
<br />Altered Sense of Time
<br />lmpaired Reaction Times
<br />Reduced Coordination
<br />Problems On The Job
<br />Accident Prone
<br />Decline ln Productivity
<br />Decline ln Quality
<br />lncrease ln Mistakes
<br />Difficulty in Prioritizing
<br />Carelessness
<br />Unauthorized Meetings ln Remote Work Areas
<br />Vehicle Accident
<br />lnjury
<br />O Absenteeism
<br />tr Arriving LateD Leaving EarlyD TardinessD Extended meal periods and/or breaksD Frequent absences from work areastr Unexplained Disappearance From Job With
<br />o Difficulty ln Locating Employee
<br />tr Frequent illness on the job
<br />O Excessive amount of personal telephone time
<br />. Excessive excused and unexcused absencesO High absenteeism rate for minor illnessesD Frequent Monday/Fridayabsences or absences
<br />whichO follow a pattern
<br />O Peculiar and improbable excuses for absencesO Asking to Leave Work Early For Different Reasons
<br />f, Relationships With Others
<br />D Edgy, lnitableD Oversensitive,Over-reactivetr lntolerantO SuspiciousD Blaming Otherstr lncreasedNervousnessn Avoids or Withdraws From Co-Workersd Problems in personal relationshipstr Over-Exaggerated Sense of Well-Being
<br />tr ArgumentativeO Extra TalkativeO WithdrawnO Disregard For Safely Of OthersE Exaggerated Sense of Self-lmportancetr Complaints From Co-Employeestr Problems With Authority Figuresn Combative
<br />D BehaviorCharacteristics
<br />n Walking: Stumbling, Staggering, Falling,
<br />Wobbling, Needs Support, Hesitant, Unable To
<br />Walk, Swaying, Unsteady, Holding OnD Standing: Swaying, Rigid, Unable To Stand,
<br />Sagging At Knees, Feei Wide Apart, DizzinessO Speech: Shouting, Whispering, lncoherent,
<br />Slurred, Mute, Slow, Slobbering, Rambling, Confus6d,
<br />Stuttered, Thick-Tongued, Mumbled, Mush-Mouthed,
<br />Cotton-Mouthed, Not Understandable, Fair, Good, Normal
<br />Demeanor: Cooperative, Polite, Unstable, Readily Open
<br />To Change, Suspicious, Crying, Laughing, Dangerous,
<br />Mood Swings, Over Reactions
<br />Actions: Resisting Communicaiion, Fighting, Drowsy,
<br />Hostile,
<br />Eyes: Bloodshot, Watery, Dilaied, Glassy, Droopy,
<br />Closed, Blurred Vision
<br />Face: Flushed, Pale, Sweaty
<br />Appearance/Clothing: Unruly, Messy, Dirty, Neat, Change
<br />ln Type Of Clothing, Wearing Of Chains, Roach Clips Or
<br />Oiher Drug-Related Accessories Or Objects, Having Odor,
<br />Partially Dressed, Bodily Excrement Stains On Clothing
<br />Breath: Alcoholic Order, Faint Alcoholic Order, No
<br />Alcoholic Order
<br />Breathing: lncreased Breathing Rate, Stuffy Or Runny
<br />Nose
<br />Body: Reduced Appetite, Weight Loss, Sweating,
<br />Headaches, Skin Disorders, Ulcers, Severe Dehydration,
<br />Digestive Disturbance, Hiccoughing, Vomiting, Belching
<br />Movements: Fumbling, Jerky, Slow, Normal, Nervous,
<br />Hyperactive
<br />Eating/Chewing: Gum, Candy, Mints, Other - ldentify:
<br />n Other Behavior Observations
<br />Non-work related accidents
<br />Accidents while working
<br />Deterioration in appearance
<br />Loss of interest, decrease in activities
<br />Overly Energetic
<br />Overly Alert
<br />Restlessness
<br />Anxiety
<br />Sleeplessness
<br />Paranoia
<br />Depression
<br />Listlessness
<br />Weariness
<br />Borrowing of money from others
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<br />APPENDIXG-Page2
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