Enter LLCS DATA for up to 10 patients

Thank you for providing valuable feedback for the LLCS!

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* 1. Please enter your contact information.

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* 2. What is your profession?

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* 3. Which certifications do you hold? (please check all that apply)

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* 4. On average, how long did it take you to complete the LLCS on one patient?

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* 5. Did you find the tool to be user friendly?

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* 6. Does the tool capture the essential aspects/complications associated with lymphedema?

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* 7. Would you use this tool in clinical practice with all your lymphedema patients?

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* 8. Ultimately, the LLCS scores will be linked to algorithms of care to guide interventions and referrals.
Do you anticipate this could help improve outcomes?

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* 9. How could the Leg Lymphedema Complexity Score be improved?

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* 10. Please enter the LLCS scores for Patient 1. Refer to the LLCS tool for complete scoring information. The subsequent questions in this survey will allow you to enter your LLCS scores for patient 2, and so on, up to 10 patients total.

  0 1 2 3 4
A Comorbidities
B Limb Volume
C Edema Texture
D Scar Tissue
E Skin Integrity
F Skin Appearance
G Fat Disorders (lipedema)
H BMI* and Body Shape
I Mobility
J ADLs**
K Pain/Discomfort (average) 0-10 scale
L Lymphedema Life Impact Scale (LLIS)

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* 11. Please enter the LLCS scores for Patient 2. Refer to the LLCS tool for complete scoring information.

  0 1 2 3 4
A Comorbidities
B Limb Volume
C Edema Texture
D Scar Tissue
E Skin Integrity
F Skin Appearance
G Fat Disorders (lipedema)
H BMI* and Body Shape
I Mobility
J ADLs**
K Pain/Discomfort (average) 0-10 scale
L Lymphedema Life Impact Scale (LLIS)

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* 12. Please enter the LLCS scores for Patient 3. Refer to the LLCS tool for complete scoring information.

  0 1 2 3 4
A Comorbidities
B Limb Volume
C Edema Texture
D Scar Tissue
E Skin Integrity
F Skin Appearance
G Fat Disorders (lipedema)
H BMI* and Body Shape
I Mobility
J ADLs**
K Pain/Discomfort (average) 0-10 scale
L Lymphedema Life Impact Scale (LLIS)

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* 13. Please enter the LLCS scores for Patient 4. Refer to the LLCS tool for complete scoring information.

  0 1 2 3 4
A Comorbidities
B Limb Volume
C Edema Texture
D Scar Tissue
E Skin Integrity
F Skin Appearance
G Fat Disorders (lipedema)
H BMI* and Body Shape
I Mobility
J ADLs**
K Pain/Discomfort (average) 0-10 scale
L Lymphedema Life Impact Scale (LLIS)

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* 14. Please enter the LLCS scores for Patient 5. Refer to the LLCS tool for complete scoring information.

  0 1 2 3 4
A Comorbidities
B Limb Volume
C Edema Texture
D Scar Tissue
E Skin Integrity
F Skin Appearance
G Fat Disorders (lipedema)
H BMI* and Body Shape
I Mobility
J ADLs**
K Pain/Discomfort (average) 0-10 scale
L Lymphedema Life Impact Scale (LLIS)

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* 15. Please enter the LLCS scores for Patient 6. Refer to the LLCS tool for complete scoring information.

  0 1 2 3 4
A Comorbidities
B Limb Volume
C Edema Texture
D Scar Tissue
E Skin Integrity
F Skin Appearance
G Fat Disorders (lipedema)
H BMI* and Body Shape
I Mobility
J ADLs**
K Pain/Discomfort (average) 0-10 scale
L Lymphedema Life Impact Scale (LLIS)

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* 16. Please enter the LLCS scores for Patient 7. Refer to the LLCS tool for complete scoring information.

  0 1 2 3 4
A Comorbidities
B Limb Volume
C Edema Texture
D Scar Tissue
E Skin Integrity
F Skin Appearance
G Fat Disorders (lipedema)
H BMI* and Body Shape
I Mobility
J ADLs**
K Pain/Discomfort (average) 0-10 scale
L Lymphedema Life Impact Scale (LLIS)

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* 17. Please enter the LLCS scores for Patient 8. Refer to the LLCS tool for complete scoring information.

  0 1 2 3 4
A Comorbidities
B Limb Volume
C Edema Texture
D Scar Tissue
E Skin Integrity
F Skin Appearance
G Fat Disorders (lipedema)
H BMI* and Body Shape
I Mobility
J ADLs**
K Pain/Discomfort (average) 0-10 scale
L Lymphedema Life Impact Scale (LLIS)

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* 18. Please enter the LLCS scores for Patient 9. Refer to the LLCS tool for complete scoring information.

  0 1 2 3 4
A Comorbidities
B Limb Volume
C Edema Texture
D Scar Tissue
E Skin Integrity
F Skin Appearance
G Fat Disorders (lipedema)
H BMI* and Body Shape
I Mobility
J ADLs**
K Pain/Discomfort (average) 0-10 scale
L Lymphedema Life Impact Scale (LLIS)

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* 19. Please enter the LLCS scores for Patient 10. Refer to the LLCS tool for complete scoring information.

  0 1 2 3 4
A Comorbidities
B Limb Volume
C Edema Texture
D Scar Tissue
E Skin Integrity
F Skin Appearance
G Fat Disorders (lipedema)
H BMI* and Body Shape
I Mobility
J ADLs**
K Pain/Discomfort (average) 0-10 scale
L Lymphedema Life Impact Scale (LLIS)

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