|
|
|
|
Primary Chief Complaint
|
CC Notes
|
|
No New Complaints
|
New Complaint
|
|
Progress
|
Intensity
|
|
Quality
• • •
|
Frequency
|
|
Relieving Factors
• • •
|
ADL
• • •
|
|
Treatment Gains
• • •
|
Regression
• • •
|
|
ROM Notes
|
|
|
Observation
• • •
|
Observation Comments
|
|
Hypertonicity / Tightness
• • •
|
Tenderness Intensity
• • •
|
|
Tightness
• • •
|
Muscle Tone Notes
|
|
Chiropractic Evaluation
• • •
|
Chiropractic Eval Notes
|
|
Assessment Notes
|
|
|
Patient Response to Tx
|
Treatment Progress
• • •
|
|
Treatment Gains
• • •
|
Treatment Gains Notes
|
|
Treatment Challenges
• • •
|
Treatment Challenges Notes
|
|
Continued Care Warranted
|
Prognosis
|
|
Spinal CMT
• • •
|
Extremity CMT
|
|
Mechanical Traction
• • •
|
|
|
Manual therapy
• • •
|
Manual Therapy Duration
|
|
Therapeutic Exercise
• • •
|
Therapeutic Exercise Duration
|
|
Therapeutic Actvities
• • •
|
Therapeutic Activity Duration
|
|
Advanced Spinal Decompression
• • •
|
Advanced Spinal Decompression Duration
/
|
|
PEMF
• • •
|
PEMF Durration
|
|
Low Level Light Therapy
• • •
|
LLLT Duration
|
|
MyACT / EPAT
• • •
|
MyACT / EPAT Duration
|
|
Dry Needling
• • •
|
Dry Needling Details
• • •
|
|
Compression Recovery Therapy
• • •
|
Compression Therapy Duration
|
|
Cryo Therapy
• • •
|
Cryo Therapy Duration
|
|
Hot Pack
• • •
|
Hot Pack Duration
|
|
Functional Movement Taping
• • •
|
Myofascial Decompression / Cupping
• • •
|
|
Muscle Vibration Therapy
• • •
|
Muscle Vibration Therapy Duration
|
|
X-Ray Orders
• • •
|
MRI Orders
• • •
|
|
Exacerbation of Symptoms
|
Post Tx Notes
|
