Follow the steps to fill out the form effectively.

1. Click the ‘Get Form’ button to access the Versorgungsformular and open it in the editor for online filling.
2. Begin by entering the patient’s name, Kundennummer, date, and only the first two letters of the first name and last name to comply with data privacy regulations.
3. Complete the patient data section which includes: selecting gender, providing age in years, entering body weight in kilograms, and height in centimeters.
4. Indicate the leg information by specifying if the left or right leg is receiving the orthosis and input shoe size according to the continental European system.
5. Choose the indication for the orthosis from the provided categories such as spinal or peripheral paralysis.
6. Describe any specific features related to the patient’s gait cycle and include details from their home environment that may impact the use of the orthosis.
7. In the activity section, select the ability level of the patient regarding mobility, ranging from indoor mobility to unrestricted outdoor mobility with high demands.
8. Fill in the details regarding mobility aids, if applicable, as well as any relevant muscle status and movement assessments, ensuring to document evaluations thoroughly.
9. Complete the orthopedic data section by specifying the type of orthosis, joint types, and materials used, ensuring all technical requirements are accurately filled out.
10. Before finalizing, review all entries for accuracy. Once confirmed, save your changes, download, print, or share the completed form as needed.

Start filling out your Versorgungsformular online today to ensure timely support.