Physical Therapy – Daily Treatment Note Mobile App

Included Fields

Customize to add, remove, or edit any of the fields below.

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  Date of Visit:

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  Patient:

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  Patient Code:

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  Physician:

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  Date of Onset:

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  Diagnosis:

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  Number of Visits to Date:

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  Number of Missed Visits to Date:

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  Time Treatment Started:

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  Time Treatment Ended:

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  Total Treatment Time:

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  I.

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  II.

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  TOTAL TIME FOR ULTRASOUND:

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  TOTAL TIME FOR MANUAL THERAPY: minimum

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  III.

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  IV.

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  Submitted by the treating therapist.

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  Therapist’s Signature

• 

  Date

• ...and More!