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Chiropractic Treatment PlanPatient Name Attending Doctor , D.C.Chief Complaint Date Diagnosis: (Please circle or insert the ICD10 codes related to this treatment plan) Cervical Dx:M99.01 Thoracic.

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How to fill out the Chiropractic Treatment Plan online

Completing a Chiropractic Treatment Plan online is a straightforward process that allows healthcare professionals to provide tailored care for their patients. This guide offers detailed steps to assist you in accurately filling out each section of the treatment plan.

Follow the steps to complete your Chiropractic Treatment Plan online.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering the patient name and the name of the attending doctor in the designated fields at the top of the form.
  3. Document the chief complaint and the date of the appointment in the appropriate sections.
  4. Specify the diagnosis by circling or inserting the relevant ICD-10 codes for the cervical, thoracic, lumbar, sacral, pelvic, and extra spinal diagnoses.
  5. For Chiropractic Manipulative Therapy (CMT), select the technique codes that support the chief complaint, clinical exam findings, and diagnosis.
  6. Detail the specific modalities to be used in treatment by filling in the relevant therapy types and targeting them towards the documented diagnoses.
  7. If there are any non-covered services recommended, ensure a waiver is signed by the patient.
  8. Set specific treatment goals that are objective and measurable, such as improving function and reducing pain.
  9. Indicate the treatment period and frequency of visits, including start and end dates and the estimated number of visits per week.
  10. Outline any patient disability and restrictions the patient may have.
  11. Provide home care recommendations such as ice or heat application, and document any supportive devices the patient should use.
  12. List recommendations for further care if treatment goals are not met.
  13. Finally, ensure that both the attending doctor and patient sign the document and date it accordingly.
  14. Once all sections are completed, save changes, download, print, or share the form as needed.

Complete your Chiropractic Treatment Plan online to provide effective care for your patients.

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The chiropractor will establish specific goals for a patient's individual treatment plan: Short-term goals typically include reducing pain and restoring normal joint function and muscle balance. Long-term goals include restoring functional independence and tolerance to normal activities of daily living.

There are typically 5 phases of chiropractic care,wellness, maintenance, supportive, corrective and pain relief.

Becoming a Chiropractor: Understanding All 3 Phases of Care Acute care to relieve pain. Corrective care to increase or optimize physical function. Long-term wellness care that includes activities, services, and guidance.

The chiropractor will establish specific goals for a patient's individual treatment plan: Short-term goals typically include reducing pain and restoring normal joint function and muscle balance. Long-term goals include restoring functional independence and tolerance to normal activities of daily living.

In the first stages of treatment of a new or acute condition, a common Chiropractic treatment program is 2 times per week for 2 to 4 weeks, followed by a re-evaluation. If you are in chronic pain, you may need to keep up regular appointments for an extended period of time until your condition improves.

Depending on the severity of the underlying condition which is causing your pain, it is typical for a patient to need chiropractic care or adjustments 2-3 times per week for 4-12 weeks.

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© Copyright 1997-2026
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Your Privacy Choices
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
altaFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2026
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232