Prepared for: Jaime Diaz(09/04/1981) Prepared by: Juan Diaz Treatment Date: 07/24/2013

Dear $[3.1.2147-Referring_Provider], National Therapy Services LLC 2, Crocker Blvd, Suite 201 Mt. Clements MI 48043 Physical Therapy Progress Note: First Name Codes 97010 97014 97035 97033 97018 97034 97022 90901 97016 97140 97124 97112 97530 97116 97110 97110-1 97704 97012 97542 97002 95831 95851 97001 Last Name Dates of Service Hot / cold pack Electrical Muscle Stimulation Ultrasound(each area) Iontophoresis (15 min. each) Paraffin Bath Contrast Bath Whirlpool Biofeedback Vasopneumatic Therapy Manual Therapy Massage Neuromuscular Re-education Transfer/Bed Mob Training Gait Training Therapeutic Exercise 15 min Therapeutic Ex Add 15 min Orthotic Training 15 min Traction Mechanical W/C Management PT Re-evaluation Manual Muscle testing ROM Measurement PT Evaluation Date of Establishment

Date Plan Established Last Name First Name Diagnosis Pain Level S: O: A: P:

Assessment: (in SOAP format)

Patients Signature

Therapists Signature

Dear $[3.1.2147-Referring_Provider],$[3.2.1403-Subjective],$[3.2.1404-Objective],$[3.2.1406-Treatment]$[3.2.1405-Assessment]$[3.2 National Therapy Services LLC

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Prepared for: Jaime Diaz(09/04/1981) Prepared by: Juan Diaz Treatment Date: 07/24/2013

2, Crocker Blvd, Suite 201 Mt. Clements MI 48043 Physical Therapy Progress Note: First Name Codes 97010 97014 97035 97033 97018 97034 97022 90901 97016 97140 97124 97112 97530 97116 97110 97110-1 97704 97012 97542 97002 95831 95851 97001 Last Name Dates of Service Hot / cold pack Electrical Muscle Stimulation Ultrasound(each area) Iontophoresis (15 min. each) Paraffin Bath Contrast Bath Whirlpool Biofeedback Vasopneumatic Therapy Manual Therapy Massage Neuromuscular Re-education Transfer/Bed Mob Training Gait Training Therapeutic Exercise 15 min Therapeutic Ex Add 15 min Orthotic Training 15 min Traction Mechanical W/C Management PT Re-evaluation Manual Muscle testing ROM Measurement PT Evaluation Date of Establishment

Date Plan Established Last Name First Name Diagnosis Pain Level S: O: A: P:

Assessment: (in SOAP format)

Patients Signature

Therapists Signature

Thank you for referring Jaime Diaz for physical therapy for his $[3.1.2148-Chief_Complaint]. Jaime was evaluated on 07/24/2013, below is a summary of their assessment:

Thank you for referring Jaime Diaz for physical therapy for his $[3.1.2148-Chief_Complaint].

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Prepared for: Jaime Diaz(09/04/1981) Prepared by: Juan Diaz Treatment Date: 07/24/2013

Jaime was evaluated on 07/24/2013, below is a summary of their assessment: Knee Operative History Presenta tension en rodilla Objective Resisted Testing Quads 3 /5 Hams 4 /5 Glut Max 4 /5 Glut Med 2 /5 Quad Set Good Presente mobilidad Flexibility Quad Normal HS Normal Assessment Long Term Goals Independent in HEP in 3 weeks. Plan Recuperacion

Patient will be treated here for physical therapy for 2-3 times a week for 4-6 weeks. Juan Diaz Thank you for referring Jaime Diaz for physical therapy for his $[3.1.2148-Chief_Complaint]. Jaime was re-evaluated on ,07/24/2013, below is a summary of their assessment: Knee Operative History Presenta tension en rodilla Objective Resisted Testing Quads 3 /5 Hams 4 /5 Glut Max 4 /5 Glut Med 2 /5 Quad Set Good Presente mobilidad Flexibility Quad Normal HS Normal Assessment Long Term Goals Independent in HEP in 3 weeks. Plan Recuperacion
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Prepared for: Jaime Diaz(09/04/1981) Prepared by: Juan Diaz Treatment Date: 07/24/2013

Patient will be treated here for physical therapy for 2-3 times a week for 4-6 weeks. Juan Diaz Operative Procedure: $[3.2.1191-Operative_Procedure] History: Presenta tension en rodilla Objective: Resisted Testing Quads 3 /5 Hams 4 /5 Glut Max 4 /5 Glut Med 2 /5 Quad Set Good Presente mobilidad Flexibility Quad Normal HS Normal

Assessment: Long Term Goals Independent in HEP in 3 weeks.

Plan: Recuperacion

Sincerely,

Juan Diaz

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