Get Annual Diabetic Foot Exam Form

Filling out the Annual Diabetic Foot Exam Form online is an essential task for individuals managing diabetes. This guide provides clear and supportive instructions to help users complete the form accurately and efficiently.

Follow the steps to effectively fill out the form

1. Click 'Get Form' button to access the form and open it in the online editor.
2. Begin by entering your name, date, and ID number in the designated fields at the top of the form.
3. In the section titled 'Presence of Diabetes Complications,' check all applicable boxes, detailing significant medical history. Specify any amputations with date and details.
4. In the 'Foot Exam' section, assess the skin, hair, and nail condition and answer accordingly.
5. Conduct a sensory foot exam, marking areas where you can or cannot feel the filament.
6. Assess footwear suitability and whether inserts or corrective shoes are necessary, answering 'Yes' or 'No' for each question.
7. In the management plan section, check all appropriate boxes regarding self-management education, diagnostic studies, footwear recommendations, and referral needs.
8. Finally, ensure all changes are saved, and you can download, print, or share the completed form as needed.

Complete your Annual Diabetic Foot Exam Form online today to ensure proper management of your health.