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Orthotic KARO Order Form Company:PO:Address:Patient Name: Shipping:Practitioner:Due Date:UPS Roundups Next Layups 2nd DayOtherPhone:KARO TypeEmail: Patient Informational ThermoplasticKAFO LaminatedAnkle
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How to fill out orthotic kafo order form
How to fill out orthotic kafo order form
01
To fill out the orthotic KAFO (Knee-Ankle-Foot Orthosis) order form, follow these steps:
02
Start by entering the patient's personal information, including their name, date of birth, and contact details.
03
Indicate the prescribing physician's name and contact information.
04
Provide the diagnosis or reason for prescribing the KAFO.
05
Specify the length measurement from the greater trochanter to the floor, taken with the knee extended and the foot in a neutral position.
06
Record the circumference measurements at specific points, such as the thigh, calf, and ankle.
07
Note any specific modifications or additions required for the orthotic device.
08
Select the appropriate size and model of the KAFO from the available options.
09
Include any additional instructions or information that may be relevant for the fabrication of the KAFO.
10
Review the completed form for accuracy and completeness before submitting it to the orthotist or supplier.
11
Keep a copy of the form for your records.
12
By following these steps, you can effectively fill out an orthotic KAFO order form.
Who needs orthotic kafo order form?
01
Orthotic KAFO order forms are typically needed by individuals who require a Knee-Ankle-Foot Orthosis as part of their orthopedic treatment or rehabilitation.
02
These individuals may have conditions such as paralysis, muscle weakness, joint instability, or post-surgical recovery that necessitate the use of a KAFO for improved mobility and support.
03
The order form ensures that the orthotic device is tailored to the specific needs and measurements of the individual, enabling the orthotist or supplier to fabricate a customized KAFO.
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What is orthotic kafo order form?
The orthotic KAFO order form is a document used to request a knee-ankle-foot orthosis (KAFO) from a healthcare provider.
Who is required to file orthotic kafo order form?
Medical professionals such as doctors, orthotists, and physical therapists are required to file the orthotic KAFO order form on behalf of their patients.
How to fill out orthotic kafo order form?
The orthotic KAFO order form must be filled out with the patient's personal information, insurance details, diagnosis, and specific measurements for the KAFO.
What is the purpose of orthotic kafo order form?
The purpose of the orthotic KAFO order form is to provide necessary information to request a knee-ankle-foot orthosis for a patient in need of orthotic support.
What information must be reported on orthotic kafo order form?
The orthotic KAFO order form must include the patient's name, date of birth, insurance information, diagnosis, measurements, and any other relevant medical details.
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