Remote Lymphedema Therapy Assessment Form

Managing lymphedema requires consistent monitoring, proper compression therapy, and ongoing patient education—but getting to in-person appointments isn't always feasible. This Remote Lymphedema Therapy Assessment Form is designed for healthcare providers, physical therapists, and lymphedema specialists who need a structured, professional way to conduct virtual lymphedema therapy sessions.

Whether you're following up with existing patients, conducting initial telehealth assessments, or providing ongoing education between clinic visits, this template helps you capture accurate limb measurements, assess symptoms, fit compression garments remotely, and deliver essential infection prevention education—all through one seamless digital form.

The form guides patients through a comprehensive self-assessment process, including visual checks, circumferential measurements at standardized points, symptom tracking, and compression garment evaluation. You can embed instructional videos for manual lymphatic drainage techniques, provide clear infection prevention protocols, and collect clinical photos for documentation—creating a complete telehealth record that supports continuity of care.

Built on Paperform, this template gives lymphedema clinics and telehealth providers the flexibility to customize questions, add conditional logic for symptom-based follow-ups, and integrate with your existing practice management or EMR systems. With secure data handling that meets healthcare compliance standards (SOC 2 Type II certified), you can confidently collect sensitive health information and clinical documentation.

Use Stepper to automate your post-submission workflows—send measurement data to your EMR, trigger follow-up appointment scheduling based on assessment results, route concerning symptoms to your clinical team for immediate review, or automatically generate patient education materials based on their specific presentation.

For practices managing multiple patients across telehealth platforms, Paperform's professional design ensures your virtual assessments feel just as thorough and trustworthy as in-person visits, helping you deliver quality lymphedema care regardless of distance.