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FORM D <br />CABARRUS COUNTY GOVERNMENT <br />OBSERVATION OF SUSPECT BEHAVIOR <br />Supervisor's Name: <br />Employee's Name: <br />Job Title: <br />Description of Work: Managerial <br />Other: <br />Office /Clerical Driver <br />How long has the employee worked for CABARRUS COUNTY GOVERNMENT: <br />How long have you supervised the employee? <br />Was the employee involved in an accident or near- accident? Yes _ No _ <br />If yes, Description: <br />Date and Time: <br />Extent of Injury to persons/Property: <br />Employee's Actions: <br />OBSERVATIONS: <br />Speech: _Mumbled _Slurred _Confused _Incoherent _Stuttering <br />Condition of Clothes: _Disorderly _Soiled _Rumpled _Orderly <br />Eyes: _Sleepy _Blood Shot _Glassy _Watery _Dilated _Closed _Alert <br />Attitude or Demeanor: _Talkative _Hyperactive _Hostile _Irritable _Nervous <br />_Depressed _Profane _Drowsy _Pleasant _Wide Mood Swings <br />Unusual Actions: _Belching _Vomiting _Fighting _Accident Prone <br />_Crying _Laughing _Runny Nose _None <br />Walking and Turning: _Stumbling _Swaying _Staggering _Arms Raised for Balance <br />_Falling _Reaching for Support _Feet Wide Apart <br />_Unable to Stand Normal <br />Awareness: _Sleepy or Stupor _Lack of Coordination _Confused _Paranoid <br />_Normal <br />21 <br />F -5 <br />Attachment number 2 <br />Page 142 <br />