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The SERF form is designed to document specific observations about a person's eating and swallowing abilities that may be noted by staff. It is intended to be completed and signed by the person(s) who made the observations, then forwarded to the RN. The RN then documents the follow-up taken to ensure the health and safety of the person.+ADULT SWALLOWING CASE HISTORY QUESTIONNAIRE ALL INFORMATION GIVEN IN THIS QUESTIONNAIRE WILL BE CONSIDERED CONFIDENTIAL!Feeding & Swallowing Case History Intake [b]Form[/b] Mansfield Pediatric Therapy One Marion Avenue Suite 107 | Mansfield, Ohio 44903 | 419-989-1416 1 Demographics Name: Date of Birth: Pr