|
Subjective:
|
|
|
History
|
|
|
Medical/Social Hx/ Co-Morbidities (that may affect recovery)
|
|
|
Chief Complaints
• • •
|
|
|
Pain Scale/VAS:
• • •
|
|
|
Reason for exacerbation
|
|
|
ADL Change/Current Functional Deficits
|
|
|
Objective:
|
|
|
Shen:
• • •
|
|
|
Complexion:
• • •
|
Tongue:
• • •
|
|
Pain/Tenderness:
|
Muscle spasm/Trigger points:
|
|
Assessment:
|
|
|
Treatment outcome:
• • •
|
|
|
TCM Diagnosis/Pattern Identification:
• • •
|
|
|
Related organs/channels:
• • •
|
|
|
Treatment:
|
|
|
Treatment Principles:
|
|
|
Initial Insertion: (97810) -15 mins
|
Initial Insertion points:
|
|
Reinsertion: (97811) -15 mins
|
1 st Reinsertion points:
|
|
Reinsertion: (97811) -15 mins
|
2 nd Reinsertion points:
|
|
Total time:
|
|
|
Note:
|
|
|
Plan of Care:
|
|
|
Frequency
|
Duration
|
|
Signature
|
|
