Request/Inquiry for Services

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Patient Info

Assessment of bathroom shower, tub, flooringHome Safety Evaluation (environmental hazards)Safety Grab Bars / Bath Safety ProductsAssessment of kitchen, hallway, etcAccessibility – ramps, etcNon-slip surface treatment, floor, tub/showerFunctional Capacity Evaluation Testing/Information

Gait or mobility problemsImpaired activities of daily livingBalance difficultiesInadequate or improper footwearLower body weakness Foot abnormalities/peripheral neuropathyFear of falling Assistive device fit & trainingSuspected neurological conditionOther

Referral Info