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Statement of Certifying Physician for Therapeutic Footwear Patient Name: ___ Address: ___ ___I certify that all the following are true: 1. This patient has diabetes mellitus ICD9 Code:___ (250.00250.93)
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How to fill out ph diabetic shoe prescription
01
Schedule an appointment with a podiatrist or healthcare provider specializing in diabetic foot care.
02
During the appointment, discuss any foot problems or concerns you are experiencing.
03
Have your healthcare provider conduct a thorough foot exam to assess your condition and determine if diabetic shoes are necessary.
04
If diabetic shoes are recommended, the healthcare provider will provide you with a prescription detailing the specific type of shoes needed.
05
Take the prescription to a qualified provider of diabetic shoes, who will help you select the appropriate pair based on your prescription and needs.
Who needs ph diabetic shoe prescription?
01
Individuals diagnosed with diabetes who are at risk of developing foot complications such as neuropathy, ulcers, or circulation issues.
02
Anyone who has foot deformities, nerve damage, or other conditions that require specialized footwear to prevent injuries and promote foot health.
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What is ph diabetic shoe prescription?
PH Diabetic Shoe Prescription is a prescription from a healthcare provider specifying the need for specialized shoes for individuals with diabetes to prevent foot complications.
Who is required to file ph diabetic shoe prescription?
Healthcare providers such as doctors, podiatrists, or orthopedic specialists are required to file PH Diabetic Shoe Prescription for their diabetic patients.
How to fill out ph diabetic shoe prescription?
To fill out a PH Diabetic Shoe Prescription, healthcare providers must include patient information, medical history, diagnosis of diabetes, foot examination findings, and specific shoe requirements.
What is the purpose of ph diabetic shoe prescription?
The purpose of PH Diabetic Shoe Prescription is to ensure that individuals with diabetes receive proper footwear to prevent or alleviate foot complications.
What information must be reported on ph diabetic shoe prescription?
Information such as patient name, date of birth, diagnosis of diabetes, foot examination findings, shoe requirements, and healthcare provider information must be reported on PH Diabetic Shoe Prescription.
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