Chiropractic Treatment Plan
Chiropractic Treatment Plan
Chiropractic Treatment Plan
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________
________
________
________
________
Sacral ___
Sacral ___
Sacral ___
Knee ___
Pelvic ___
Pelvic ___
Pelvic ___
Ankle ___
Extraspinal
Bending
Pushing/ Pulling
Twisting
Walking
Lifting Avoid lifting over _________ pounds
MRI
CT Scan
Nerve Conduction Velocity Test
Other _________________________________________________________
(If patient successfully meets treatment goals at completion of this plan period)
Supportive / Maintenance Chiropractic Care