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Progress Report (SOAP)
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Subjective
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Pain Scale
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Pain Comments
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Objective
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TONGUE
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Color
• • •
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Color Comments
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Shape
• • •
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Shape Comments
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Coating
• • •
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Coating Comments
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Cracks
• • •
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Cracks Comments
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Other Tongue Comments
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PULSE
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Left Cun
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Left Guan
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Left Chi
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Right Cun
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Right Guan
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Right Chi
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AB PALPATION
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Epigastric Hardness [-]
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Epigastric Hardness [+]
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Subcostal Tightness [-}
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Subcostal Tightness [+]
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Water Splash [-]
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Water Splash [+]
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Rikyu [-]
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Rikyu [+]
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Pulsations [-]
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Pulsations [+]
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Subumb.drop/Bowtie [-]
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Subumb.Drop/Bowtie [+]
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Oketsu [-]
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Oketsu [+]
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Ab Palpation Diagram
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Assessment
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Plan
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Treatment Type
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Acupuncture
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Points/Notes
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# of needles used
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Bleeding
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Points/Notes
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Cupping
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Method
• • •
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Location/Notes
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Ear Seeds
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Notes
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Ear Diagram
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Electrical Stimulation
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Settings/Frequency
• • •
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Points/Notes
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Gua Sha
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Notes
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Full Body Diagram
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Kinesiology Tape
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Reason
• • •
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Full Body Diagram
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Notes
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Moxibustion
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Method
• • •
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Notes/Location
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Moxibustion (2)
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Method
• • •
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Notes/Location
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Herbal Prescription (1)
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Formula
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Type
• • •
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Granules
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Capsules/Pills
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How many times per day?
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Special Instructions
• • •
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Notes:
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Herbal Prescription (2)
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Formula
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Type
• • •
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Granules
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Capsules/Pills
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How many times per day?
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Special Instructions
• • •
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Notes:
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Herbal Prescription (3)
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Formula
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Type
• • •
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Granules
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Capsules/Pills
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How many times per day?
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Special Instructions
• • •
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Notes:
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