|
Chief Complaint
|
Cervical Physical Exam
|
|
# injection in the current series
|
Relief from previous injection
|
|
Complications
|
Complication comments
|
|
Procedure Dx, Therapeutic or both
|
|
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Bilat FJI C3-4,C4-5,C5-6 Medicare, Blues
|
Bilat FJI C3-4,C4-5,C5-6 all others
|
|
Side
|
First Level
|
|
Similar proc was performed on levels
• • •
|
|
|
Anesthetic Used
|
|
|
Complications
|
Complication comments
|
|
Follow Up
• • •
|
Follow up comments
|
