Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ Introduction ++ Table Graphic Jump Location|Download (.pdf)|Print Patient Name: Date of Evaluation: Location: Type: Measurements (Length x Width x Depth): Wound Base: Signs/Symptoms of Infection (Yes/No): Girth Measures: Sensation: Peripheral Pulses: Other Tests (TCP02, Vascular Studies, X-Rays, Labs, etc.): Consultations (MD, Rehab, Social Services, Home Health, Diabetes Education, etc.): Treatment Plan (include plan, DME, home dressing supplies): 1. 2. 3. 4. 5. 6. Your Access profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth