Get the free ottobock pp afo form

Phone: 800.354.5418 Fax: 877.655.0326 AFO Order Form For a speedy start to your job, complete the form below completely & carefully. The accuracy of the device is related to the accuracy of your measurements.

How to fill out ottobock pp afo form

Steps to fill out the Ottobock PP AFO form:

1. Start by filling out the personal information section, which includes your name, date of birth, address, and contact information. Ensure all details are accurate.
2. Next, provide details about the prescribing physician, including their name, address, and contact information. If you are a healthcare professional filling out the form, include your own information instead.
3. The form will likely have a section asking for the patient's medical history. Include any relevant information, such as previous injuries or surgeries, current medications, or existing health conditions.
4. If applicable, describe the patient's current condition or impairment for which the Ottobock PP AFO is being prescribed. This could include information about gait abnormalities, muscle weakness, or balance issues.
5. Indicate any specific features or modifications needed in the AFO design. This may include adjustments to accommodate foot deformities, enhance stability, or provide additional support. Be as specific as possible.
6. There might be a section for additional notes or special instructions. Use this space to provide any extra information that is relevant to the prescription or customization of the AFO.
7. Finally, carefully review all the information provided to ensure accuracy and completeness. Make any necessary corrections before submitting the form to the appropriate entity, such as the orthotist or supplier.

Who needs Ottobock PP AFO form?

1. Individuals who require an ankle-foot orthosis (AFO) to aid in walking or improve lower limb function.
2. Those with foot drop, muscle weakness, or gait abnormalities that need assistance to stabilize their ankle and foot.
3. Patients with conditions such as cerebral palsy, multiple sclerosis, stroke, or spinal cord injuries that affect their lower limb function and require orthotic intervention.
4. Healthcare professionals, such as orthotists, physiotherapists, or physicians, who prescribe or provide AFOs to their patients. They may need the form to document and communicate the specific requirements or modifications needed for the AFO.

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