Get Wy Chiropractic Patient Exam/re-exam Form 2016-2026

Filling out the WY Chiropractic Patient Exam/Re-exam Form online can seem daunting, but with the right guidance, it becomes a straightforward process. This guide walks you through each section of the form to ensure that you accurately complete it for optimal care.

Follow the steps to complete the form effectively.

1. Press the ‘Get Form’ button to access the form and open it in the online editor.
2. Start by entering the patient’s name and claim number at the top of the form, along with the current date.
3. Indicate whether the patient has been discharged from care by checking 'Yes' or 'No.' If 'Yes,' provide the discharge date and sign the form; then return it via fax to 307-777-6552.
4. If the patient has not been discharged, proceed to complete the form fully, beginning with the number of prior treatments.
5. In the section labeled 'Current Subjective Complaints,' write down any current symptoms the patient is experiencing.
6. For 'Activities of Daily Living Limitations or Duties Under Duress,' describe any difficulties the patient faces in routine tasks.
7. Document any exacerbations since the last exam in the designated section.
8. Complete the 'Current Orthopedic / Neurologic Evaluation' field with relevant observations.
9. Measure and record the range of motion in the specified areas (cervical, thoracic, lumbar) by checking the appropriate boxes for normal or current, noting any pain.
10. Conduct muscle strength tests and document the results in the provided space.
11. Fill out the P.D.Q. scores section with the necessary information.
12. Provide a summarizing assessment of the patient’s condition.
13. In the 'Plan' section, outline the next steps or treatment plans for the patient.
14. Add any additional information or complicating factors that may affect the patient's care.
15. Finally, ensure the doctor of chiropractic's name and signature are included at the bottom of the form.
16. Once you have completed all the sections of the form, save your changes. You can then choose to download, print, or share the completed document as needed.

Start filling out the WY Chiropractic Patient Exam/Re-exam Form online today to ensure precise and effective documentation.