Clinical evaluation and assessment of a patients orthotic or prosthetic needs is largely a posteducation skill that develops and improves with experience. Unfortunately, evaluating and assessing a patients needs has not traditionally been included in the formal education of most O&P practitioners. Until recently, it truly was a skill practitioners had to develop with clinical experience. However, the O&P professional practicing in todays healthcare environment is called upon to render and document specific recommendations for O&P care. Since O&P is both a clinical and technical science, a practitioners procedures for assessing, evaluating and documenting must be sufficient to appropriately determine a patients specific need for O&P services. The process a practitioner uses to clinically assess and evaluate a patients needs must justify the need for O&P services. This article addresses the key elements of the clinical assessment and evaluation of a patient needed for the documentation and justification of O&P services.