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CC#1:
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CC#2:
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CC#3:
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CHIEF COMPLAINTS: CC#1: Pain _____/10
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CC#2: Pain _____/10
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CC#3: Pain _____/10
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Subluxation levels: C/S:____
• • •
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T/S:____
• • •
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L/S:____
• • •
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SI
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ExSpinal
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ASSESSMENT
• • •
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Additional Assessment
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Phase of Care
• • •
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Progress
• • •
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