Get Hanger Clinic Order Forms

Filling out the Hanger Clinic Order Forms online can be a straightforward process. This guide provides you with clear instructions on how to complete each section of the form, ensuring that all necessary information is provided accurately and efficiently.

Follow the steps to effectively complete the Hanger Clinic Order Forms online.

1. Click ‘Get Form’ button to access the Hanger Clinic Order Forms and begin the filling process in your preferred format.
2. In the 'Patient Information' section, fill in the patient's name, sex, date of birth, height, and weight. These details are essential for identifying the individual receiving the assessment.
3. Respond to the 'Medical Necessity' section by indicating if there are any comorbidities affecting the patient’s mobility and ability to use a prosthesis. Provide explanations where necessary.
4. Answer the questions regarding the patient’s ability to function with a prosthesis by selecting 'Yes' or 'No' in the respective fields.
5. Explain the reasoning for prosthesis replacement if applicable. If the patient does not have a prosthesis, mark the appropriate box and move to question #2.
6. In the 'Desire to function with a Prosthesis' section, detail how the patient has shown a desire to use a prosthesis.
7. In the 'Ability to function with a Prosthesis' section, check all mobility aids currently used by the patient.
8. Check the aids the patient may need after being fitted with a prosthesis.
9. In the 'Current and Expected Functional Level' section, fill in the current and expected functional level according to the provided definitions, and explain any discrepancies between the two.
10. Complete the 'Multi-Discipline Corroboration' section by checking the professionals consulted and providing additional comments or observations as necessary.
11. Finally, sign and date the form at the bottom of each page, ensuring all information is correct before proceeding.
12. Once you have filled out all relevant sections, save your changes, download, print, or share the form as needed.

Complete your Hanger Clinic Order Forms online today and ensure a smooth process for prosthetic assessments.