| Visit Note |  | 
| Appointment Type | CC | 
| Accident Details | HPI | 
| Past Medical HX | Past Surgical HX | 
| Medications | Allergies | 
| Social HX | Family HX | 
| ROS | Physical Exam | 
| Radiographic Imaging | Diagnostic Injections | 
| EMG / NCS | PT / Chiro | 
| Pre-Op Medical Clearance | Laboratory Studies | 
| Chest X-Ray | EKG | 
| Assessment | Impression, Recommendations, and Plan | 
| EMC |  | 
| Procedure Note |  | 
| Trina-Murillo Scribe Attestation | Danielle-Murillo Scribe Attestation | 

