|
Subjective
|
|
|
Improvement?
|
Pain # after last tx
|
|
Next pain #
|
Overall status
|
|
Objective & Assessment
|
Focus / Diagnosis
|
|
Phys Findings 1
• • •
|
Location 1
• • •
|
|
Techniques 1
• • •
|
Comments
|
|
Phys Findings 2
• • •
|
Location 2
• • •
|
|
Techniques 2
• • •
|
Comments
|
|
Phys Findings 3
• • •
|
Location 3
• • •
|
|
Techniques 3
• • •
|
Comments
|
|
Phys Findings 4
• • •
|
Location 4
• • •
|
|
Techniques 4
• • •
|
Comments
|
|
Trigger Points
• • •
|
Deep Tissue
|
|
Carrier Oils & Essential Oils
|
Essential Oil(s) A-C
• • •
|
|
Essential Oil(s) D-G
• • •
|
Essential Oil(s) H-L
• • •
|
|
Essential Oil(s) M-P
• • •
|
Essential Oil(s)R-Z
• • •
|
|
Essential oil comments
|
Massage Total Time (min)
|
|
Post treatment changes
|
Post tx pain #
|
|
Notes for Next Visit
|
|
