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MANUAL LYMPH DRAINAGE THERAPY CONFIDENTIAL PATIENT HISTORY FORM Name Address Postal Code Birthdate (month / day / year) Family Doctor Phone Referring Professional Phone (home) Phone (cell/pager) (work)
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How to fill out manual lymph drainage formrapy

01
To fill out a manual lymph drainage form, follow these steps:
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Start by entering the patient's personal information, including their name, date of birth, and contact details.
03
Next, provide details about the patient's medical history, including any existing medical conditions, surgeries, or allergies.
04
Document the reason for seeking manual lymph drainage therapy, including symptoms or specific areas of concern.
05
Record any previous treatments or therapies the patient has undergone for the same condition.
06
Include information about the patient's current medication or supplement intake.
07
Assess and document the patient's lymphatic system, including any areas of swelling, tenderness, or discomfort.
08
Note any contraindications or precautions that should be taken during the therapy.
09
Provide a detailed treatment plan, including the recommended frequency, duration, and techniques to be used.
10
Lastly, obtain the patient's signature and date to acknowledge their consent and agreement with the provided information.
11
Remember to review and confirm the accuracy of the filled-out form before proceeding with the therapy.

Who needs manual lymph drainage formrapy?

01
Manual lymph drainage therapy is typically beneficial for individuals who experience the following conditions:
02
- Lymphedema: A condition where excess fluid accumulates in the tissues, causing swelling and discomfort.
03
- Post-surgical swelling: Individuals who have undergone surgery, especially involving lymph nodes, may benefit from this therapy to reduce swelling and promote healing.
04
- Detoxification and immune support: Manual lymph drainage therapy can help stimulate the lymphatic system, aiding in the removal of toxins and boosting immune function.
05
- Chronic venous insufficiency: People with this condition, characterized by inadequate blood flow from the legs back to the heart, may find relief from symptoms like leg swelling and discomfort.
06
- Fibromyalgia: Manual lymph drainage therapy has shown positive results in managing pain and improving overall well-being in individuals with fibromyalgia.
07
However, it is important to consult with a trained healthcare professional or therapist specialized in manual lymph drainage to determine if this therapy is suitable for specific individuals.
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Manual lymph drainage therapy is a specialized type of massage that encourages the natural drainage of the lymph, which carries waste products away from the tissues back toward the heart.
Generally, healthcare professionals such as physical therapists or massage therapists who provide manual lymph drainage therapy may be required to file documentation or treatment plans related to this therapy.
To fill out manual lymph drainage therapy documentation, you typically need to include patient information, treatment goals, techniques used, session details, and therapist’s observations or recommendations.
The purpose of manual lymph drainage therapy is to improve lymph circulation, reduce swelling, alleviate pain, and promote overall relaxation and wellness.
Information reported should include patient demographics, diagnosis, treatment plan, techniques used, duration of treatment, and any outcomes or changes observed.
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