Service Provider Forms

ATTENTION SOADI SERVICE PROVIDERS. THE SOADI OFFICE WILL BE CLOSED DECEMBER 23 FOR TWO WEEKS. WE WILL RE OPEN JANUARY 9th. ANY INVOICES SUBMITTED WILL BE PROCESSED IN THE NEW YEAR.

THANK YOU AND HAPPY HOLIDAYS

 

SOADI Subsidy E-Invoice

Online form for submitting individual invoices to SOADI Foot Care. Password required, please contact SOADI Foot Care for more information.

SOADI Ongoing E-Invoice

Online form for submitting invoices for ongoing clinics. Passworkd required, please contact SOADI Foot Care for more information.

SOADI Foot Care Policies and Procedures Manual

This manual is for service providers who are registered within the SOADI Foot Care Program. It gives all the information regarding the policies and procedures relating to the Foot Care Program.

Service Provider Information Package

The information package is for all service providers who participate in the SOADI Foot Care Clinics. It gives all the necessary information of what a clinic looks like as well as frequently asked questions.

Service Provider Agreement Form

The agreement form is for all new service providers to the SOADI Foot Care Program. If you are interested in being registered with the SOADI Foot Care Program, please review policies and procedures, as well as fill out agreement form and send in to SOADI Foot Care Program.

Service Provider Clinic Evaluation

The clinic evaluation is for all service providers who have participated in a SOADI Foot Care Clinic.

Foot Care Specialist Screening Form

The Screening form is used to all new Foot Care clients, as well as for Foot Care clinics and subsidy. 

 

Assessment Form Risk Level Legend Description

Category 0:  No evidence of pathology but simply has been diagnosed with diabetes. There is no neuropathy present and the patient has no history of previous diabetic foot complication.

 Category 1: Loss of protective sensation (peripheral neuropathy).

These patients who are in risk category 1 are twice as likely to ulcerate than patients in risk category 0.

Category 2:  Peripheral sensory neuropathy in combination with a predisposing foot deformity.

This foot deformity could be as simple as contracted digits and intrinsic atrophy from muscle wasting. These simple foot deformities in the diabetic population present with significant risk factor for ulceration.  Patients in foot risk category 2 are 12 times more likely to ulcerate than are category 0 foot types according to the UT system. 

Category 3:   Presents with a history of pathology.

This pathology can be an amputation now healed, it can be a history of a previous ulceration, or can be a history of previous Charcot joints. These patients who present with this history of ulcer, amputation, or Charcot joints history are 36 times more likely to develop foot ulceration than patients in foot risk category 0. 

Category 4:     

4a.  Active neuropathic ulceration which requires appropriate debridement, offloading, and local care.

4b. Active neuropathic Charcot arthropathy of the diabetic lower extremity. 

Category 5:  Active diabetic foot infection,

which requires generally hospital admission, IV antibiotics, and surgical debridement. 

Category 6:  Severe and acute peripheral arterial disease.

These patients generally require intervention by vascular surgery if possible and will often times also require some level of amputation

 

 

 

Step Up with SOADI

Foot Care DVD