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Height
Weight
Blood Pressure
/
Pulse
Cervical Spine Flexion
Pain with C/S flexion?
Cervical Spine Extension
Pain with C/S extension?
Cervical Spine Right Lateral Fle
Pain with C/S Rt. lateral flex?
Cervical Spine Left Lateral Flex
Pain with C/S Lt. lateral flex?
George's Maneuver Positive?
Foramina Compression
• • •
Shoulder Depression
• • •
Cervical Distraction Positive?
Bakody's Sign
Adson's Sign
Eden's Sign
Isometric C/S Extension
/
Isometric C/S Flexion
/
Isometric Left Lateral Flexion
/
Isometric C/S Right Lateral Flex
/
Biceps Reflex
• • •
Triceps Reflex
• • •
Patellar Reflex
• • •
Achilles Reflex
• • •
L/S Flexion
Pain with L/S flexion?
L/S Extension
Pain with L/S extension?
L/S Right Lateral Flexion
Pain with L/S right lateral flex
L/S Left Lateral Flexion
Pain with L/S left lateral flex?
Trendelenberg Test
• • •
Kemp's Test
• • •
Advancement
• • •
Posture
• • •

Chiro Physical Exam Medical Form

Chiropractor

There are 45 copies in use.
Published: Jan. 28, 2016, 8:49 a.m.
Doctor: Dr. History Physical
Rating: +10   /

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