Create a Clinical Success Story | Life Care Centers of America

Generate a Document

1. Step One

Enter your contact information.

Name*

Email*

Job Title*

Facility*

2. Step Two

Tell us about your patient.

Patient Name*

Primary Physician*

Referral Source*

Diagnosis/Reason for Therapy*

Please select no more than 12.

Physical Therapy

	Admission	Discharge
Gait
Bed mobility
Transfers
Wheelchair mobility
Sitting balance
Standing balance
Stairs

Occupational Therapy

	Admission	Discharge
Personal Care
Self-feeding
Dressing
Medication management

Speech Therapy

	Admission	Discharge
Cognition
Receptive language
Expressive language
Speech
Voice
Swallowing

Quote* Please include the patient's initial reason for admission, the plan of action, and the success(es) of therapy and what the patient is now able to do again. Including quotes from the patient and/or therapist is also encouraged. Maximum of 180 characters.

3. Step Three

Upload a photo.

File Upload Guidelines

Click the "Upload Files" button below to launch the uploader
You may upload a maximum of 1 file
File size limit is 10 MB
File types accepted: .jpg, .png, and .heic (iPhone)
Photos will be automatically cropped in a square format. Make sure to keep photo subjects in the center.

I have obtained permission and completed a waiver for the patient listed above. If photo includes therapists, I have a signed waiver on file for each therapist pictured.

Yes*

I verify that in each photo I submitted with unmasked residents and/or associates, EVERY resident and/or associate pictured is FULLY vaccinated.

Yes*

I have obtained ED and/or DOR approval to produce this document.

Yes*

Is this story approved for social media distribution?*