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Diagnosis of CF
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Color***
• • •
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Sound***
• • •
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Odor***
• • •
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Emotion***
• • •
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Observations
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Physical Discomfort/Pain***
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Shen***
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Stuckness***
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Energy/Vitality***
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Motivation***
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Connection to Self***
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Warmth***
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Connection to Outer World***
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Flexibility/Resiliency***
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Fluidity***
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Emotional Strength***
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Hopefullness***
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Temperature (deficiency/excess)... TCM
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Tension***
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JAD
• • •
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Physical or Mental/Emotional Evaluation
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Functional Response (+)***
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Functional Response (-)***
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Additional Notes
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Tongue Fur***
• • •
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Tongue Body
• • •
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General WNL
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General Abnormal
• • •
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General Comments
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HEENT WNL
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HEENT Abnormal
• • •
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HEENT Comments
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Skin WNL
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Skin Lesion
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Skin Comments
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Neck WNL
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Neck Abnormal
• • •
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Neck Comments
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Cardiovascular WNL
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Cardiovascular Abnormal
• • •
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Cardiovascular Comments
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Lungs WNL
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Lungs Abnormal
• • •
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Lungs Comments
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Abdomen WNL
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Abdomen Abnormal
• • •
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Abdomen Comments
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MSK WNL
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MSK Abnormal
• • •
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MSK Comments
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Breasts WNL
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Breasts Abnormal
• • •
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Breasts Comments
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Neuro WNL
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Neuro Abnormal
• • •
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Neuro Comments
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Extremities WNL
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Extrem Abnormal
• • •
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Extrem Comments
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