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Functional Mobility & Wheelchair Assessment

HOME ENVIRONMENT: House Condo/town home Apartment Asst living LTCF Own Rent Lives alone Lives with others - Hours without assistance: Home is accessible to patient Storage of wheelchair: In home Other Comments: COMMUNITY : TRANSPORTATION: Car Van Public Transportation Adapted w/c Lift Ambulance Other: Sits in wheelchair during transport

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  Assessment, Home, Functional, Wheelchairs, Mobility, Functional mobility amp wheelchair assessment

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Functional Mobility & Wheelchair Assessment

www.numotion.com

The least costly alternative for independent functional mobility was found to be: Crutch/Cane Walker Manual w/c Manual w/c with power assist Scooter Power w/c std joystick Power w/c alternative control Requires . dependent care. mobility device . Functional Processing Skills for Wheeled Mobility

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Wheelchair, Medical necessity, Home, Skilled Nursing Facility Consolidated Billing as, Medical, AAC Evaluation for a SGD