Center for Integrative Oncology and Survivorship (CIOS) Oncology Rehabilitation Lymphedema Management Program 900 W. Faris Rd Greenville, SC 29605 P: 864-455-1346 F: 864-455- 5897

Dear Patient,

The Center for Integrative Oncology and Surviovorhsip (CIOS), Oncology Rehabilitation/ physical therapy has received a referral from your doctor recommending physical therapy to address possible lymphedema issues. Your initial evaluation is scheduled below. This visit is to evaluate any issues you are having, provide education about lymphedema, and assess your treatment needs. You and your physical therapist will determine your plan of care. Please:

 Fill out the enclosed questionnaire and bring the completed form with you to your appointment.

 Call at least 24 hours prior to your appointment if you are unable to make your appointment.

 Bring your calendar so you can schedule once you and your therapist have determined your plan of care.

 Bring any garments or supplies you have used in the past.

Your treatment and understating of lymphedema is extremely important to us. Please arrive 15 minutes early to help ensure that your appointment can begin on time. You may be asked to reschedule if you are more than 20 minutes late.

Appointment Date:______

Appointment Time:______

Oncology Rehabilitation Physical Therapist Scheduler: 864-455-1346

Thank you,

Kathie Campbell Beldon, PT, CLT

Oncology Rehabilitation Physical Therapist