Follow the steps to successfully complete the CDFE form online.

1. Press the ‘Get Form’ button to access the form and open it in your preferred document editor.
2. Begin by filling in the patient information in the specified fields, including patient name, date, and medical record number. Ensure accuracy while entering details to avoid discrepancies.
3. Input the name of the office or clinic conducting the CDFE and the supervising physician’s name (MD/DO), along with their signature in the certifying physician acknowledgment section.
4. Document significant dates, such as the last palliative foot care, last visit by the certifying physician, last CDFE, last fasting blood sugar (FBS), and last HbA1c. This information is essential for tracking the patient's diabetic management.
5. List the medications and allergies of the patient accurately to inform subsequent treatment decisions.
6. Reflect on the estimated duration of diabetes and any specific foot complaints reported by the patient. This will guide the evaluation process.
7. Conduct a review of symptoms by checking all applicable boxes, including orthopedic, dermatological, neurological, vascular, and endocrine symptoms. This comprehensive history is crucial for an effective examination.
8. Complete the physical examination section by noting findings such as digital deformities, pressure assessment, and temperature comparisons of both feet.
9. Evaluate the patient's footwear, noting brand names, types, and conditions. Record whether the fit is good or if adjustments are necessary.
10. Assess risk stratification based on the patient's condition and document the recommended exam frequency, ranging from annual to monthly follow-ups.
11. In the education and counseling section, provide necessary explanations about diabetes risks, foot care instructions, and medication review to ensure patient understanding and compliance.
12. Make sure to document all prescriptions, referrals, and diagnostic studies as required.
13. Conclude by ensuring that the certifying physician acknowledges the completion of the form by signing and dating it.
14. Finally, save changes to the form, and choose the option to download, print, or share the completed document as needed.

Complete your comprehensive diabetic foot exam form online today to ensure proper management and care for your patients.