Chiropractic Exam ROMS/Soft Tissue

Range of motion: 
Ranges of motion were as follows: [checkbox name="ROMS" value="Cer Flex|Cer Ext|Cer LLF|CER RLF|CER LR|CER RR| LUM FLEX|LUM EXT|LUM LLF|LUM RLF|LM ROT|LUM RR"] were found to be [select name="DECNORM" value="Slightly Decreased|Moderately Decreased|Severely Decreased|Normal|"] due to pain and stiffness as reported by the patient. 

Fixations of the following levels were found: [checkbox name="Fixations" value="C1|c2|C3|C4|C5|C6|C7|C8|T1|L1|L2|L3|L4|L5|S1"]

Soft tissue and muscles: 
[checkbox name="Muscles" value="SubOcc|Traps|Lev Scap|Rhomboids|Erectors|QLs|Glutes|Hamstrings|Piriformis"] were found to be [select name="TautTen" value="Taut and tender|normal"] with an MAS Grade of [select name="MAS" value="0|1|2|3"]
Any other observations noted: [textarea name="Observations" default=]
Range of motion:
Ranges of motion were as follows: were found to be due to pain and stiffness as reported by the patient.

Fixations of the following levels were found:

Soft tissue and muscles:
were found to be with an MAS Grade of
Any other observations noted:

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.86, 7 form elements, 47 boilerplate words, 1 text areas, 3 checkboxes, 3 drop downs, 40 total clicks
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