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SUBJECTIVE
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Subjective Profile
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OBJECTIVE
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Preformatted Notes
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General Spinal Therapy | 60 Minutes
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Full Body Diagram
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Additional Information About Patient (Dictate)
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Region Specific Treatments
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Cervical / Thoracic Spine
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Cervical Musculature Treated
• • •
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Spasm Measurement
• • •
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Adhesions/Trigger Points
• • •
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Pain On Palpation Measurment
• • •
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Treatment Duration For This Region(s)
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Additional Notes (Dictate)
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Lumbar Spine / Pelvis
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Lumbar Spine / Pelvic Musculature
• • •
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Spasm Measurement
• • •
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Adhesions | Trigger Points
• • •
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Pain On Palpation Measurment
• • •
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Treatment Duration For This Region(s)
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Additional Notes (Dictate)
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Upper Extremity
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Upper Extremity Musculature
• • •
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Spasm Measurement
• • •
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TrPs:
• • •
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Pain On Palpation Measurment
• • •
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Treatment Duration For This Region(s)
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Additional Notes (Dictate)
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Lower Extremity
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Lower Body Musculature
• • •
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Spasm Measurement
• • •
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Adhesions/Trigger Points
• • •
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Pain On Palpation Measurment
• • •
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Treatment Duration For This Region(s)
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Additional Notes (Dictate)
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Assessment: Post Treatment
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Response To Treatment
• • •
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Next Patient Visit
• • •
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Progress Affected By
• • •
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Homecare Recommendations
• • •
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Plan
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Type Of Massage
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Sports Massage
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Swedish Massage
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Neuromuscular Massage
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Prenatal Massage
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Myofascial Release Treatment
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Abdominal Massage
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Lymphatic Massage
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Post Surgical Massage
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Specific Techniques Performed
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Cupping
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Deep Tissue
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Cross-Fiber Massage
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Trigger Point Therapy
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TMJ Dysfunction Massage
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Contract/Relax
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IASTM
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Kinesiology Tape
• • •
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