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PTOT WALKER ASSESSMENT FORM - healthcareinnovations

PTOT WALKER ASSESSMENT FORM - healthcareinnovations 2025

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The document is a PT/OT Walker Assessment Form used to evaluate a patient's mobility needs and goals for selecting an appropriate walker. It includes sections for subjective information about the patient's mobility goals, current living environment, and past funding access, as well as objective assessments of their current mobility aids, ambulation status, standing balance, and gait. The form also assesses compatibility with the patient's living environment and includes space for assessment findings and a summary plan by the ADP Authorizer.

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