Forms

We ask that a General Health History form is filled out prior to your first appointment and that a hard copy is brought with you. Those with an appointment relating to lymphatic or lymphedema care are asked to fill out both the General Health History and a Lymphedema Health History form.  If you prefer, you can fill out the forms at the clinic but please arrive 15 minutes prior to your appointment time.

General Health History (pdf)

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Lymphedema Health History (pdf)

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Forms

Compression garments for Lymphedema can be partially funded by the Assistive Devices Program (up to 75%). On the first page of the form below lists the specialists that are able to prescribe for ADP funding. Please don't hesitate to contact us with any questions you have when navigating this paperwork.

ADP application for funding (pdf)

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