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Becker KAFOHKAFO Orthometry Form free printable template

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KARO/HK AFO OPTOMETRY FORM: Today s Date: Patient: Facility: Age: Sex: Ht: Street: Diagnosis: City: State: Zip: Orthotic: Delivery Date: Phone Number: PO Number: Wt: MEASUREMENTS: ? Inches ? Centimeters
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How to fill out Becker KAFO/HKAFO Orthometry Form

01
Start by gathering all necessary measuring tools, such as a measuring tape and a protractor.
02
Have the patient wear appropriate clothing that allows for easy measurement.
03
Measure the height of the patient from the floor to the top of the head.
04
Record the shin circumference just below the knee.
05
Measure the calf circumference at the widest part of the calf.
06
Take the thigh circumference at the widest part of the thigh.
07
Measure the distance from the hip joint to the ankle joint while the patient stands.
08
Measure the foot length from the heel to the tip of the longest toe.
09
Document any specific patient needs or conditions in the designated section.
10
Review all measurements for accuracy before finalizing the form.

Who needs Becker KAFO/HKAFO Orthometry Form?

01
The Becker KAFO/HKAFO Orthometry Form is needed for individuals who require orthotic support due to conditions affecting their mobility, such as spinal cord injuries, neurological disorders, or severe limb weakness. Patients needing customized orthotic devices would also require this form.
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The Becker KAFO/HKAFO Orthometry Form is a document used to collect and record specific measurements and data related to Knee-Ankle-Foot Orthoses (KAFO) and Hip-Knee-Ankle-Foot Orthoses (HKAFO), which are devices used to support individuals with lower limb disabilities.
Healthcare professionals, such as orthotists or physical therapists, who are involved in the design and fitting of KAFOs or HKAFOs, are required to file the Becker KAFO/HKAFO Orthometry Form.
To fill out the Becker KAFO/HKAFO Orthometry Form, practitioners must take precise measurements of the patient's lower limbs, ensure all required fields are completed, and provide additional clinical notes as necessary for proper device fabrication.
The purpose of the Becker KAFO/HKAFO Orthometry Form is to ensure accurate fabrication of orthotic devices by providing detailed and organized measurements and observations that inform the design and fit of the device for optimal patient support.
The information that must be reported on the Becker KAFO/HKAFO Orthometry Form includes patient identifiers, detailed measurements such as limb lengths, joint angles, and any special considerations regarding the patient's medical condition or treatment goals.
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