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subjective
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pain location
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pain level
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ROM
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Ortho, palp and other
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Gait, Posture, Movement
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ART Tx
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Laterality - DO NOT LEAVE BLANK!!
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Adhesions
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Laterality
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Adhesions
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Laterality
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Adhesions
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Laterality
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Adhesions
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Laterality
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Adhesions
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long nerve
• • •
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Plan- ART treatment highlights
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Plan for future treatment
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ART Tx Response
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Tx notes
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Ren Ying - Cun Kou Pulse Dx
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Ren Ying vs Cun Kou Pulse Size
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(L) Ren Ying vs Cun Kou Pulse Size
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(R) Ren Ying vs Cun Kou Pulse Size
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Cun Kou vs Ren Ying Pulse Size
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(L) Cun Kou vs Ren Ying Pulse Size
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(R) Cun Kou vs Ren Ying Pulse Size
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(L) vs (R) Ren Ying Pulse Size
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(R) vs (L) Ren Ying Pulse Size
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(L) vs (R) Cun Kou Pulse Size
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(R) vs (L) Cun Kou Pulse Size
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Ren Ying- Cun Kou Pulse notes
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Ren Ying- Cun Kou Pulse notes
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"Zao" - Ren Ying Cun Kou Pulse
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Meridian Dx from Ren Ying Cun Kou Pulse
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Acup Meridian Dx
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Acup Tx Plan (Do not leave blank!!)
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Pulse Dx
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Pulse diagram
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Pulse overall
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Pulse (R)
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Pulse (L)
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R - 3 pulse positions:
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(R) Cun:
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(R) Guan:
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(R) Chi:
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L - 3 pulse positions:
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(L) Cun:
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(L) Guan:
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(L) Chi:
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Pulse notes
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Pulse notes
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Dr Tan Acup
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Scalp Acup
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Scalp Acup notes
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Scalp (center line & paraspinal)
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Center line & Paraspinal:
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Scalp (L)
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(L):
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Scalp (R)
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(R):
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Upper (R)
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Upper (R) Acup notes
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UR- Extra points
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Extra points
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UR - Yang Meridians
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UR- LI
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LI point(s)
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UR- SJ
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SJ point(s)
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UR- SI
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SI point(s)
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UR - Yin Meridians
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UR- LU
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LU point(s)
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UR- PC
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PC point(s)
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UR- HT
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HT point(s)
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Upper (L)
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Upper (L) Acup notes
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UL- Extra points
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Extra points
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UL Yang Meridians
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UL- LI
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LI point(s)
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UL- SJ
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SJ point(s)
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UL- SI
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SI point(s)
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UL - Yin Meridians
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UL- LU
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LU point(s)
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UL- PC
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PC point(s)
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UL- HT
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HT point(s)
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Lower (L)
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Lower (L) Acup notes
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LL- Extra points
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Extra points
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LL - Yang Meridians
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LL- ST
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ST point(s)
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LL- GB
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GB point(s)
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LL- UB
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UB point(s)
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LL - Yin Meridians
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LL- SP
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SP point(s)
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LL- LR
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LR point(s)
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LL- KI
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KI point(s)
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Lower (R)
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Lower (R) Acup notes
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Lr- Extra points
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Extra points
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Lr - Yang Meridians
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Lr- ST
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ST point(s)
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Lr- GB
|
GB point(s)
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Lr- UB
|
UB point(s)
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Lr - Yin Meridians
|
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Lr- SP
|
SP point(s)
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Lr- LR
|
LR point(s)
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Lr- KI
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KI point(s)
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Plan-Acup treatment UR
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Plan-Acup treatment UL
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Plan-Acup treatment LR
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Plan-Acup treatment LL
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Plan-Acup treatment Rt
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Plan-Acup treatment Lt
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Plan-Acup treatment Bilateral
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Plan-Acup treatment Bilateral
|
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Plan-Acup treatment
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Plan-Acup treatment
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Second round needle applications
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Second round needle application notes
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Needle insertion
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Needle insertion notes
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Needle insertion Rt
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Needle insertion Lt
|
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Needle insertion Bilateral
|
Needle insertion Bilateral
|
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Needle insertion
|
Needle insertion notes
|
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Needle removal
|
Needle removal notes
|
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Needle removal Rt
|
Needle removal Lt
|
|
Needle removal
|
Needle removal notes
|
|
Acup Tx Response
|
Acup Tx notes
|
|
Myofascia Release
|
Plan for future treatment
|
|
Spinal Adjustments
• • •
|
Spinal adjustment comments
|
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Other Treatment 1
|
Other Treatment 2
|
|
Overall Tx Response
|
Overall Tx notes
|
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Exercises - if performed, DO NOT LEAVE BLANK!!
|
Pre-Set Exercises
• • •
|
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Exercise notes
|
Stretching Exercises
• • •
|
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Exercise notes
|
at home exercises
• • •
|
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Treatment Notes
|
Total Exercise time
|
