Home
Forms Library
Foot care assessment template

Foot assessment form 2025

foot care assessment template Preview on Page 1

Show details

4.8 out of 5

41 votes

The document is a Foot Risk Assessment Form designed for diabetic patients, outlining various findings related to foot health, including skin condition, nail status, anatomical structure, sensation, vascular health, foot care practices, and appropriate footwear. It categorizes risk levels (low, moderate, high) based on the assessment results and provides an action plan for management and referrals to specialists as needed. The form emphasizes the importance of regular foot assessments and education on maintaining healthy feet to prevent complications.

Here's how it works

01. Edit your foot care assessment template online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send foot assessment form pdf via email, link, or fax. You can also download it, export it or print it out.

How to rapidly redact Foot assessment form online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Dochub is the best editor for modifying your documents online. Follow this straightforward instruction to edit Foot assessment form in PDF format online at no cost:

Sign up and log in. Register for a free account, set a strong password, and proceed with email verification to start managing your forms.
Add a document. Click on New Document and select the file importing option: upload Foot assessment form from your device, the cloud, or a secure link.
Make changes to the sample. Take advantage of the top and left-side panel tools to modify Foot assessment form. Add and customize text, images, and fillable areas, whiteout unnecessary details, highlight the significant ones, and provide comments on your updates.
Get your paperwork done. Send the form to other parties via email, generate a link for quicker file sharing, export the sample to the cloud, or save it on your device in the current version or with Audit Trail included.

Try all the advantages of our editor right now!

See more foot assessment form versions

We've got more versions of the foot assessment form form. Select the right foot assessment form version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2015	4.8 Satisfied (41 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What are three things you should never do to the feet of someone with diabetes?

Stage 0. At this stage, there are no open sores or ulcers. The foot appears normal.

What are the 5 stages of diabetic foot?

Wagner-Meggitt Classification of Diabetic Foot Grade 0 - Foot symptoms like pain, only. Grade 1 - Superficial ulcers involving skin and subcutaneous tissue. Grade 2 - Deep ulcers involving ligaments, muscles, tendons, etc. Grade 3 - Ulcer with bone involvement. Grade 4 - Forefoot gangrene. Grade 5 - Full-foot gangrene.

What do bad diabetic feet look like?

The 5-year overall survival of patients with diabetic foot ulcers (DFUs) is 70%, and after a major amputation, it declines to only 43% (2). The most important risk factors for mortality in patients with DFUs are age, ischemia, impaired renal function, and male sex (35).

How long is the life expectancy with diabetic foot?

To avoid hurting your skin, dont use a nail file, nail clipper or scissors on calluses, corns or warts. Dont use chemical wart removers. See your provider or foot specialist (podiatrist) to remove any of these issues. Cut your toenails carefully.

What is included in a foot assessment?

Observe the feet, comparing one with the other for symmetry. Look specifically at the forefoot for nail changes or skin rashes, such as psoriasis. Look for alignment of the toes, evidence of hallux valgus of the big toe or subluxation (partial dislocation) of the joints.

foot risk assessment form

Diabetic foot Assessment Form Diabetic foot exam form PDF Printable diabetic foot exam form Medicare diabetic foot exam form Diabetic foot exam documentation example Basic foot assessment checklist Diabetic foot exam soap Note Comprehensive Diabetes Foot Examination Form

Related forms

be ready to get more

Complete this form in 5 minutes or less

Get form

What are the first signs of diabetes in your feet?

Diabetes Foot Problems: When to See Your Doctor Tingling, burning, or pain in your feet. A change in the color and temperature of your feet. Dry, ed skin on your feet. Loss of feeling or ability to sense heat or cold. Thick, yellow toenails. Loss of hair on your toes, feet, and lower legs.

What would you assess when caring for the feet?

The examination should include assessment for neuropathy, skin changes (e.g. calluses, ulcers, infection), peripheral arterial disease (e.g. pedal pulses and skin temperature) and structural abnormalities (e.g. range of motion of ankles and toe joints, bony deformities) [Grade D, Level 4 (1)].

Foot assessment form 2025

Here's how it works

How to rapidly redact Foot assessment form online

See more foot assessment form versions

Complete this form in 5 minutes or less

Got questions?

What are three things you should never do to the feet of someone with diabetes?

What are the 5 stages of diabetic foot?

What do bad diabetic feet look like?

How long is the life expectancy with diabetic foot?

What is included in a foot assessment?

Complete this form in 5 minutes or less

People also ask

What are the first signs of diabetes in your feet?

What would you assess when caring for the feet?

pdf foot assessment form

Try more PDF tools