Assessment & Plan Elements
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-Likely contributing factors: [checkbox value="repetitive use with poor mechanics & poor conditioning|muscle strain|muscle spasm|joint/ligament sprain|muscle weakness|osteoarthritis|somatic dysfunction(osteopathic)|neuropathy|referred pain|disc degeneration|spinal stenosis|disc herniation|occult fracture|joint/ligament instability|joint degeneration|anxiety|depression|opioid-induced hyperalgesia"]. [text size="80"]
-Unlikely factors: [checkbox value="osteoarthritis|joint/ligament instability|joint degeneration|neuropathy|referred pain|disc degeneration|spinal stenosis|disc herniation|occult fracture"]. [text size="80"]
-Assessment of progression/prognosis: [checkbox value="acute injury & too early to tell|likely self-limited & anticipate full recovery|anticipate at least partial recovery, unclear & workup will help further assess this|improving with current treatments|not improving with current treatments|concern for worsening"]. [text size="80"]
-Recommended workup @ this time:
[checkbox value="--Xray
"][checkbox value="--CT
"][checkbox value="--MRI
"][checkbox value="--EMG
"][checkbox value="--None"][text size="80"]
-Recommended treatments @ this time:
[checkbox value="--rest
"][checkbox value="--ice/heat
"][checkbox value="--early mobilization
"][checkbox value="--splinting
"][checkbox name="stretches" value="--home stretches"][conditional field="stretches" condition="(stretches).is('--home stretches')"] - [checkbox value="demonstrated|provided handout"] [text size="50"]
[/conditional][checkbox name="meds" value="--medications"][conditional field="meds" condition="(meds).is('--medications')"] - [checkbox value="NSAIDS|tylenol|muscle relaxer|transdermal lidocaine patches|topical capsaicin"]. [text size="80"]
[/conditional][checkbox value="--physical therapy
"][checkbox name="referral" value="--referral to"][conditional field="referral" condition="(referral).is('--referral to')"] - [checkbox value="sports medicine|orthopedics|PM&R|chiropractic"] [textarea]
[/conditional][checkbox name="OMT" value="--OMT"][conditional field="OMT" condition="(OMT).is('--OMT')"] - [checkbox value="scheduled with myself|scheduled with another physician"] [text size="50"]
[/conditional]-Explained the above assessment and plan to patient who: [select value="|acknowledged understanding and intent to follow through with plan|desires second opinion"]
-Likely contributing factors: .
-Unlikely factors: .
-Assessment of progression/prognosis: .
-Recommended workup @ this time:

-Recommended treatments @ this time:
-Explained the above assessment and plan to patient who:
Result - Copy and paste this output: