GTK Rehab - Rehabilitation Technology Supplier.
	
Referral form - Measurements.

To measure: Client should be supported in upright sitting on a firm surface with feet flat.  Please provide "body" not "wheelchair" measurements. 

Actual Body Measurements in millimetres.

A. Height from seat surface to top of head.
B. Height from seat surface to top of shoulder.
C. Height from seat surface to armpit.
D. Height from seat surface to base of scapular.
E. Height from seat surface to elbow (arm at side with elbow bent at right angles).
F. Height from seat surface to hip.
G. Width from behind knee to backrest.
H. Height from heel to back of knee.
I. Foot length from heel to tip of big toe
J. Chest depth from front of body to seat back
K. Shoulder width.
L. Chest width.
M. Hip width (from greater trochanter to great trochanter).
N. Space between knees when comfortably seated (from inside edge of left knee to out inside of right knee).
O. Width from outer edge of left knee to out edge of right knee.

If measurement is taken in supine please indicate.

Compiled for use by GTK Rehab and customers, June 2003.

End of form.