OFP objective exam template

Objective:

Physical Exam/Relevant Findings noted below: 
Neuro Exam (CN 2-12): WNL and alert and oriented x3
Gait: WNL
Extraoral: WNL
Mallampti: [select name="variable_mallampati" value="I|II|III|IV"]
Tonsil: [select name="variable_mallampati" value="0|I|II|III|IV"]
Tongue scalloping: [select name="variable_three levels" value="none|mild|moderate|severe"]
Cheek ridging:  [select name="variable_three levels" value="none|mild|moderate|severe"]
Attrition:  [select name="variable_three levels" value="none|mild|moderate|severe"]

Mandibular ROM(mm): 
Opening path: [select name="variable directions2" value="straight|left|right|left and right"][select name="deviation/deflection" value="no deviation/deflection|deflection|deviation"]
Comfort jaw opening:  [select name="measurement" value="1|2|3|4|	5|6|7|8|9|10|11|12|13|14|15|16|17|18|19|20|21|22|23|24|25|26|27|28|29|30|31|32|33|34|35|36|37|38|39|40|	41|42|43|44|45|46|47|48|49|50|51|52|53|54|55|	55+"]
Active jaw opening: [select name="measurement" value="1|2|3|4|5|6|7|8|9|10|11|12|13|14|15|16|17|18|19|20|21|22|23|24|25|26|27|28|29|30|31|32|33|34|35|36|37|38|39|40|41|42|43|44|45|46|47|48|49|50|51|52|53|54|55|	55+"]
[select name="pain level" value="no pain|mild pain|moderate pain|severe pain"][checkbox name="pain location" value="right TMJ|right masseter|left TMJ|Left masseter"]
[select name="pain level" value="no pain|mild pain|moderate pain|severe pain"][checkbox name="pain location" value="right TMJ|right masseter|left TMJ|Left masseter"]
Passive jaw opening: [select name="measurement with n/a" value="1|n/a|2|3|4|5|6|7|8|9|10|11|12|13|14|15|16|17|18|19|20|21|22|23|24|25|26|27|28|29|30|31|32|33|34|35|36|37|38|39|40|41|42|43|44|45|46|47|48|49|50|51|52|53|54|55|	55+"][select name="end feel" value="soft|hard|n/a"]
[select name="measurement with na" [select name="pain level" value="no pain|mild pain|moderate pain|severe pain"][checkbox name="pain location" value="right TMJ|right masseter|left TMJ|Left masseter"]
[select name="measurement with na" [select name="pain level" value="no pain|mild pain|moderate pain|severe pain"][checkbox name="pain location" value="right TMJ|right masseter|left TMJ|Left masseter"]


Protrusive jaw opening: 
[select name="variable_1" value="-3|-2|-1|0|1|2|3|4|5|6|7|8|9|10"]+[select name="variable_1" value="-3|-2|-1|0|1|2|3|4|5|6|7|8|9|10"]
Right Lateral jaw movement:[select name="measurement lateral"value="0|1|2|3|4|5|6|7|8|9|10|11|12|13|14|15"]
Left Lateral jaw movement: [select name="measurement lateral"value="0|1|2|3|4|5|6|7|8|9|10|11|12|13|14|15"]
Mandibular Midline Position: [select name="measurement lateral with zero" value="0|1|2|3|4|5|6|7|8|9|10|11|12|13|14|15"]
[select name="variable_directions" value="straight|left|right"]
[text name="variable_1" default="sample text"]


TMJ Evaluation: 
Noise: 
[select name="left/right" value="left|right|bilateral"] [checkbox name="clicking and crepitus" value="no click|early opening click|mid opening click|late opening click| early closing click| mid closing click| late closing click|no crepitus| mild crepitus| moderate crepitus| severe crepitus| reduced with tongue blades"]



[select name="right/left" value="right|left|bilateral"][checkbox name="clicking and crepitus" value="no click|early opening click|mid opening click|late opening click| early closing click| mid closing click| late closing click|no crepitus| mild crepitus| moderate crepitus| severe crepitus| reduced with tongue blades"]
Palpation (pain): 
Orthopedic manipulation (pain): 

General Dental Evaluation
Intraoral: OCS negative. No gross periodontal disease. No gross dental decay. Soft tissues appear grossly wnl. 
Occlusion R - MPCI, ICPM - L: ++++, ++++
Missing dentition: Third molars 

Bite Maneuvers (pain/significant findings noted): 
Intercuspal clench: wnl
Right Separator: wnl
Left separator: wnl
Bilateral separator: wnl

Myofascial Exam(pain/significant findings noted): 
Masseter:
Temporalis:
Trapezius:
SCM:
Occipital Nerves:
Splenius Capitus: 
Other: 

Imaging/Report: none

Other Exam/Dx.Testing: