Get Physical Therapy Initial Evaluation Form
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How to fill out the Physical Therapy Initial Evaluation Form online
Filling out the Physical Therapy Initial Evaluation Form is an essential step in receiving appropriate care and treatment. This guide will walk you through each section of the form, ensuring you provide all necessary information accurately and efficiently.
Follow the steps to complete the evaluation form online.
- Click ‘Get Form’ button to access the form and open it in the designated online editor.
- Begin by entering your personal details in the 'Patient Information' section. Fill in your name, birthdate, age, and occupation. Ensure that all information is accurate to avoid any discrepancies.
- Provide your height, home or cell phone number, and indicate if you are currently employed. Enter your weight and employer details as well.
- Move to the 'Rehab Information' section. Here, describe your chief complaint, ailment, or injury in detail. Make sure to include the date of injury and, if applicable, the date of any surgery.
- Indicate whether you have received therapy for this condition by selecting 'yes' or 'no.' If applicable, state when your therapy took place and how many visits you completed.
- Assess your condition by indicating whether it has been getting worse, the same, or better. Additionally, note if your symptoms are constant or intermittent.
- On a scale from 0 to 10, indicate your pain level at its best and worst. Use the provided scale to mark the appropriate numbers.
- Identify factors that relieve your condition by marking all applicable options. Consider movements, positions, and treatments that help your symptoms.
- Similarly, mark all factors that worsen your condition. Be thorough in identifying situations that exacerbate your symptoms.
- In the 'Previous Medical Intervention' section, mark any tests or procedures you have undergone, such as X-rays or MRIs.
- Outline your therapy goals at the end of the form. Clearly stating your expectations can significantly enhance your treatment plan.
- In the 'Medical Information' section, mark all relevant health conditions and any previous surgeries. Also, list medications and allergies to ensure comprehensive health documentation.
- Once all sections of the form have been filled out, review your entries for accuracy. Save your changes, and you can then download, print, or share the form as needed.
Complete your Physical Therapy Initial Evaluation Form online today to ensure your treatment is tailored to your needs.
To prepare for your physical therapy evaluation, consider bringing any relevant medical records, previous imaging results, and a list of medications you are currently taking. Completing the Physical Therapy Initial Evaluation Form beforehand can streamline the process, allowing the therapist to focus on your individual situation more effectively. Lastly, wear comfortable clothing that allows for easy movement during the assessment.
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