Foot assessment form 2026

1. Click ‘Get Form’ to open the foot assessment form in the editor.
2. Begin by entering your name and date of birth in the designated fields. Ensure accuracy for proper identification.
3. Indicate your Medicare number and answer the diabetic status question by checking 'Yes' or 'No'.
4. Proceed to the 'EXAM FINDINGS' section. Here, select options that best describe your skin condition, nails, structure, anatomy, sensation, and vascular health by checking the appropriate boxes.
5. In the 'FOOT CARE' and 'FOOTWEAR' sections, assess your current practices and mark any areas needing improvement or education.
6. Complete the risk assessment by assigning a score based on your findings. This will help determine necessary actions.
7. Finally, ensure you sign and date the form at the bottom before saving or sharing it directly from our platform.

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