II. Indications: Physical Therapy

  1. Adaption to new Impairment
  2. Significant balance or gait disturbance
  3. Ambulatory aid training
  4. Wheelchair (new, adjust seating and positioning)
  5. Significant strength or ROM Impairment
  6. Mobility or transfer difficulty

III. Indications: Occupational Therapy

  1. ADL assistance
  2. Adaptation to new Disability
  3. Limited judgment regarding safety
  4. Splint or Orthotic fabrication
  5. Adaptive equipment for work
  6. Home environment assessment

IV. Indications: Speech and Language Evaluation

  1. Swallowing difficulty
  2. Verbal or written language expression or reception
    1. Unable to fill out MC forms or office ID sheet
    2. Unable to tell biographical info for medical history
    3. Can't tell why he or she in your office
  3. Cognitive language difficulty
    1. Can not maintain topic or train of thought
    2. Can not retrieve info
    3. Confusion
  4. Deterioration in speech, language or cognition

V. Indications: Audiologist

  1. Difficulty hearing face to face communication
  2. Complains that everyone mumbles
  3. Needs questions or instructions repeated
  4. Difficult hearing over telephone
  5. Needs television louder than other family or friends

VI. Indications: Low-Vision Specialist

  1. Difficulty with printed materials (forms, labels)
  2. Due to reduced vision:
    1. Needs others for guidance
    2. Avoids outdoors or social activities
    3. Eye treatment has not Restored sight for independence

VII. Indications: Home health or Community Agency

  1. Assistive Technology assessment
  2. Home evaluation stressing
    1. Safety
    2. Function
    3. Accessibility

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