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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 Office /Clerical <br />Other: <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: <br />Disorderly Soiled Rumpled <br />Orderly <br />Eyes: Sleepy <br />Blood Shot Glassy Watery <br />Dilated Closed Alert <br />Attitude or Demeanor: <br />Talkative Hyperactive Hostile <br />Irritable Nervous <br />Depressed Profane Drowsy <br />Pleasant Wide Mood Swings <br />Unusual Actions: <br />Belching Vomiting Fighting <br />Accident Prone <br />Crying Laughing Runny Nose <br />None <br />Walking and Turning: <br />Stumbling Swaying Staggening <br />Arms Raised for Balance <br />Falling Reaching for Support <br />Feet Wide Apart <br />Unable to Stand Normal <br />Awareness: <br />Sleepy or Stupor Lack of Coordination <br />Confused Paranoid <br />Normal <br />OBSERVATION OF SUSPECT BEHAVOR (continued) <br />21 <br />Driver <br />Attachment number 1 <br />F -6 Page 132 <br />