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Side and Location of Complaint
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What does it feel like?
• • •
|
|
Pain at Lowest and Highest
/
|
Affected Activities?
• • •
|
|
How often do you feel the complaint
|
%Improve since last tx
• • •
|
|
Quality Improve since last tx
• • •
|
%Improve since 1st tx
• • •
|
|
|
Cont Tx Plan?
|
|
|
|
|
Total Duration of Visit
|
|
|
97140 Minutes/Units
/
|
|
|
97112 Minutes/Units
/
|
97110 Minutes/Units
/
|
