Get Custom Seamed Lower Extremity Measurement Form - Jobst

Filling out the Custom Seamed Lower Extremity Measurement Form - Jobst online is a straightforward process that ensures accurate measurements for lower extremity support. This guide will provide you with step-by-step instructions to help you complete the form efficiently.

Follow the steps to successfully fill out the form online.

1. Press the ‘Get Form’ button to obtain the Custom Seamed Lower Extremity Measurement Form and open it in your document editor.
2. Enter the date in the section labeled 'Date'. This helps in tracking the measurement session accurately.
3. In the 'Patient’s Name or File #' field, input the name of the patient or their relevant identification number for reference.
4. Specify the prescribed pressure in mmHg in the designated space. Choose the correct level based on your healthcare provider's instructions.
5. Indicate the severity level of the condition by selecting either Mild, Moderate, or Severe. This is important for determining suitable support.
6. In the 'Quantity' (QTY) section, list the number of garments needed for each style, clarifying whether they are for the left or right leg.
7. Select the appropriate styles from the provided list (e.g., Anklet, Knee Length), ensuring you check the corresponding left or right leg as needed.
8. For leg circumferences, measure and document the circumferences of both legs in the allotted spaces, specifying left and right accurately.
9. Choose options for pleats, colors, and any reinforcement or lining preferences based on your requirements.
10. Complete the torso/body measurements section, including waist and hip circumferences, height, and proximal thigh measurements as indicated.
11. Conclude by reviewing all entries for accuracy. Once satisfied, save your changes, then download, print, or share the form as needed.

Start completing your Custom Seamed Lower Extremity Measurement Form online today to ensure all your details are accurately captured.