|
Subjective
|
|
|
Present Complaint
|
Secondary Complaint
|
|
Other Complaint 1
|
Other Complaint 2
|
|
Are you currently in any pain?
|
Pain Description
|
|
Trigger Points:
|
Strength:
|
|
ADL:
|
|
|
Objective
|
|
|
Objective - Tongue
• • •
|
Objective - Pulse
|
|
Objective - Physical Exam
|
|
|
Assessment
|
|
|
ASSESSMENT:
|
|
|
Plan
|
|
|
Plan -Procedure
• • •
|
|
|
Face Up?
|
|
|
Plan - Acu Rx Face Up
• • •
|
Plan - Acu Rx Face Down
• • •
|
|
Progress
|
|
|
Progress
|
Additional Notes:
|
|
New Field
|
|
