Class Entry Page - Home Rehabilitation Network

Enter Scheduled Appointment

Directions:

Before your appointment, please complete the Daily Vitals form below.
Next, click on your doctor’s profile picture (below) to enter your session.
When you are done, please complete your Daily Therapy Journal using the therapy Journal link under your doctor’s profile.

If your assigned clinician requests a 6 Minute Walk Test, please find the required form below.

Note: Please come into class on time and be ready to workout. Keep camera at least 3 ft. away to provide a proper visual perspective for the clinician, so they can see you and not just your face. Having issues? Please contact support at 410-871-4601.

1: Enter Current Vitals

2. Join Your Scheduled Appointment

3. Six Minute Walk Test (if directed)

Date of Test*

Full Legal Name*

Date of Birth:*

What is the distance will you be using during the test? (Example: I measured 35 feet from the bedroom door to the kitchen table going one direction; so the answer is 35 feet) Note: If you're using a treadmill then put down "0" as your answer.

Will you be using any assist devices (Walker, Cane..)?*

Current blood pressure reading (120/70)?*

6 Minute Walk Test directions:

Before starting please understand that you can walk fast but safety comes first. Please wear proper attire and proper shoes. Find an area in your home that is greater than 10 feet. Measure out your distance making sure the area you're doing the test in, is in satisfactory condition to prevent injury. Use a timer and walk from your point "A" to your Point "B" back and forth till the six minutes is up. At the 3 minute interval write down what your oxygen levels on your pulse oximeter is at followed by your Heart rate, BORG scale, pain level and how many laps did you do at 3 minutes. (Note: Keep your pulse ox on your fingure during the test so at the 3-minute mark you're not taking too much time waiting for your oxygen numbers and Heart Rate to read) At the 6 minute interval stop, sit down if possible and calculate how many feet you did or taking your distance from point A" to Point "B" and multiply your laps with your measured distance. Fill out each section of data fields before submitting your test.

Before starting

How much oxygen will you be using during the test? (If you do not wear oxygen then select "0" in the field below)

What is your SP02% on your pulse oximeter?*

What is your Heart Rate reading on your pulse oximeter?*

How out of breath (BORG) do you feel currently? (0-10, 10 is the worst, 0 is the least)

Rate your pain found anywhere around your body, 0- least, 10 is the worst; If your pain found anywhere around the body is above a "5" or you don't feel comfortable doing the test because of the pain then do not continue, end the test and report to your doctor.

3 Minutes

How much oxygen are you still on? (If you do not wear oxygen then select "0" in the field below)

What is your SP02% on your pulse oximeter at 3 minutes?*

What is your Heart Rate reading on your pulse oxymeter at 3 minutes?*

How out of breath (BORG) do you feel currently at 3 minutes? (0-10, 10 is the worst, 0 is the least)

Rate your pain found anywhere around your body at your 3 minutes, 0- least, 10 is the worst; If your pain found anywhere around the body is above a "5" or you don't feel comfortable doing the test because of the pain then do not continue, end the test and report to your doctor.

How many laps have you done so far at 3 minutes?

Text

How much oxygen are you still on at the end of the test? (If you do not wear oxygen then select "0" in the field below)

What is your SP02% on your pulse oximeter at 6 minutes?*

What is your Heart Rate reading on your pulse oximeter at 6 minutes?*

How out of breath (BORG) do you feel currently at 6 minutes? (0-10, 10 is the worst, 0 is the least)

Rate your pain found anywhere around your body at your 3 minutes, 0- least, 10 is the worst

How many laps did you complete in total for the whole test?

Click to continue

Direction

Directions:

How bad has your coughing been (0- I never cough, 5- I cough all the time)?

Phlegm (mucus) in your chest. (5: My chest is always filled with phlegm, 0- I have no phlegm or mucus in my chest at all)

Chest tightness (0-my chest does not feel tight at all, 5- My chest always feels tight)

How bad does my breathing get when I walk up a slight hill or one flight of stairs (0- When I walk up a hill or a flight of stairs I am not out of breath, 5- When I walk up a hill or a flight of stairs I am very out of breath)?

How limited to I feel when doing activities (0- I am not limited to doing any activities at home, 5- I am completely limited to doing all activities at home)?

How well do you sleep (0- I sleep soundly, 5- I don't sleep soundly at all)?

How energetic have you been feeling (0- I have lots of energy, 5- I have no energy at all)?

Click to continue

Enter Scheduled Appointment

Directions:

1: Enter Current Vitals

Please enter your current vitals before entering class:

2. Join Your Scheduled Appointment

Melanie's Therapy Class

Channon's Therapy Class

Alex G's Therapy Class

Milly's Therapy Class (Spanish)

Dr. Naveed Shah, MD

3. Six Minute Walk Test (if directed)

HELPFUL VIDEOS FOR BEFORE YOUR FIRST LIVE SESSION

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