Assessment & Plan Elements
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#[select name="MSKBLUF" value="|New/Acute Injury|Chronic Condition 1st Assessment|Chronic Condition Followup"][conditional field="MSKBLUF" condition="(MSKBLUF).isNot('')"]
[/conditional][checkbox name="MSKBLUFfreetext" memo="Freetext for general gestault if desired" value=""][conditional field="MSKBLUFfreetext" condition="(MSKBLUFfreetext).is('')"][textarea rows="2"]
[/conditional]-Likely contributing factor(s): [checkbox value="repetitive use|poor mechanics/ergonomics/form|inadequate conditioning|muscle strain|muscle spasm|joint/ligament sprain|muscle weakness|tendinopathy|osteoarthritis|somatic dysfunction(osteopathic)"][checkbox name="MSKcontribfxother" memo="other" memo_size="small" value=""][conditional field="MSKcontribfxother" condition="(MSKcontribfxother).is('')"][checkbox value="neuropathy|referred pain|disc degeneration|spinal stenosis|disc herniation|occult fracture|joint/ligament instability|joint degeneration|anxiety|depression|opioid-induced hyperalgesia"][checkbox name="MSKcontribfxfreetext" memo="freetext" memo_size="small" value=""][/conditional][conditional field="MSKcontribfxfreetext" condition="(MSKcontribfxfreetext).is('')"] , [text size="80"][/conditional]
-Unlikely factor(s): [checkbox value="neuropathy|joint/ligament instability|occult fracture"][checkbox name="MSKunlikelyfxother" memo="other" memo_size="small" value=""][conditional field="MSKunlikelyfxother" condition="(MSKunlikelyfxother).is('')"][checkbox value="osteoarthritis|tendinopathy|joint degeneration|referred pain|disc degeneration|spinal stenosis|disc herniation"][checkbox name="MSKunlikelyfxfreetext" memo="freetext" memo_size="small" value=""][/conditional][conditional field="MSKunlikelyfxfreetext" condition="(MSKunlikelyfxfreetext).is('')"], [text size="80"][/conditional]
-Assessment of progression/prognosis: [checkbox name="MSKmildprog" memo="select for acute mild self-limited injury options" memo_size="small" value=""][conditional field="MSKmildprog" condition="(MSKmildprog).is('')"][checkbox value="mild severity|moderate severity|acute injury|likely self-limited|anticipate full recovery"]
[/conditional][conditional field="MSKmildprog" condition="(MSKmildprog).isNot('')"][checkbox value="mild severity|moderate severity|acute injury|likely self-limited|anticipate full recovery|anticipate at least partial recovery|likely progressive degenerative process|prognosis unclear|workup will help further assess prognosis|encouraging|improving with current treatments|not improving with current treatments|concern for worsening|has not yet met MRDP|has met MRDP and will referral for MEB"]. [checkbox name="MSKprogother" memo="assessment/prognosis freetext" memo_size="small" memo_color="orange" value=""][/conditional][conditional field="MSKprogother" condition="(MSKprogother).is('')"][textarea rows="2"][/conditional][conditional field="MSKmildprog" condition="(MSKmildprog).isNot('')"]
[/conditional]-Recommended workup @ this time: [checkbox name="MSKworkupnone" value="--None
"][conditional field="MSKworkupnone" condition="(MSKworkupnone).isNot('--None
')"][checkbox value="--Xray
"][checkbox value="--CT
"][checkbox value="--MRI
"][checkbox value="--EMG
"][checkbox name="MSKworkupfreetext" memo="workup freetext" memo_size="small" memo_color="orange" value=""][/conditional][conditional field="MSKworkupfreetext" condition="(MSKworkupfreetext).is('')"][textarea rows="2" cols="80"]
[/conditional]-Recommended treatments @ this time:
[checkbox value="--rest
"][checkbox value="--ice/heat
"][checkbox value="--early mobilization
"][checkbox value="--splinting
"][checkbox name="profile" value="--work/duty restrictions issued|--duty-limiting profile issued"][conditional field="profile" condition="(profile).is('--work/duty restrictions issued')||(profile).is('--duty-limiting profile issued')"] x [text size="5"] [select value=days|weeks|months|indefinite period"], [textarea rows="3" default="specific limitations-"]
[/conditional][checkbox name="stretches" value="--home stretches/exercise plan"][conditional field="stretches" condition="(stretches).is('--home stretches/exercise plan')"] - [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="--continue formal physical therapy
"][checkbox name="referral" value="--referral to"][conditional field="referral" condition="(referral).is('--referral to')"] - [checkbox value="formal physical therapy|sports medicine|orthopedics|PM&R|chiropractic|pain management"] [textarea]
[/conditional][checkbox name="OMT" value="--OMT"][conditional field="OMT" condition="(OMT).is('--OMT')"] - [select value="|performed (see note)|scheduled with myself|scheduled with another physician"] [text size="50"]
[/conditional]-Followup plan: [select name="MSKFUvisit" value="|no f/u visit needed|f/u in-"][conditional field="MSKFUvisit" condition="(MSKFUvisit).is('f/u in-')"] [text size="5"] [select value="day(s)|week(s)|month(s)"] with [select value="|PCM|unit provider|physical therapist|orthopedist"]. [checkbox name="MSKFUfreetext" memo="f/u freetext" memo_size="small" memo_color="orange" value=""][/conditional][conditional field="MSKFUfreetext" condition="(MSKFUfreetext).is('')"][textarea rows="3"][/conditional][conditional field="MSKFUvisit" condition="(MSKFUvisit).is('no f/u visit needed')"]
-Gave the following return precautions: [checkbox name="MSKreturnprecaut" value="fever|severe progressive pain|progressive/severe swelling|inability to bear weight|new onset numbness|new onset weakness|other-"][/conditional][conditional field="MSKreturnprecaut" condition="(MSKreturnprecaut).is('other-')"] [textarea rows="2"][/conditional]
-Explained the above assessment and plan to patient who: [select value="|acknowledged understanding and intent to follow through with plan|desires second opinion"]
# Freetext for general gestault if desired-Likely contributing factor(s): other
-Unlikely factor(s): other
-Assessment of progression/prognosis: select for acute mild self-limited injury options-Recommended workup @ this time: -Recommended treatments @ this time:
-Followup plan:
-Explained the above assessment and plan to patient who:
Result - Copy and paste this output: