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Exhibit 12 Physical Rehabilitation Review Worksheet For Preservice Review Providers are required to submit review requests via the Quails Health web based review system, exchange. Please see section
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How to fill out physical rehabilitation review worksheet

01
The Physical Rehabilitation Review Worksheet is typically used by healthcare professionals, such as physical therapists, occupational therapists, or rehabilitation specialists.
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It is mainly used to assess and document the progress and outcome of a patient's rehabilitation program.
03
To fill out the worksheet, start by entering the patient's basic information, such as name, age, and contact details.
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Next, provide an overview of the patient's diagnosis or condition for which rehabilitation is being conducted.
05
It is important to include details about previous medical history, surgeries, or treatments related to the condition.
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The worksheet will also have sections to record detailed information about the patient's functional abilities and limitations.
07
This may include their mobility, strength, range of motion, balance, coordination, and any other relevant physical or cognitive factors.
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Documenting the patient's goals for rehabilitation and their progress towards achieving those goals is another crucial aspect of filling out the worksheet.
09
Be sure to include specific details about the interventions, techniques, or exercises being utilized during the rehabilitation process.
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The worksheet should also have space for recording any modifications or adjustments made to the treatment plan based on the patient's response and progress.
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Additionally, it is important to document any challenges or obstacles encountered during the rehabilitation program and how they were addressed.
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Finally, the worksheet may include sections for summarizing the patient's overall progress, outcomes, and recommendations for further treatment or follow-up.
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Overall, the Physical Rehabilitation Review Worksheet serves as a comprehensive record of the patient's rehabilitation journey and aids in evaluating the effectiveness of the interventions provided.
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What is physical rehabilitation review worksheet?
Physical rehabilitation review worksheet is a form used to assess the progress and effectiveness of a patient's rehabilitation program.
Who is required to file physical rehabilitation review worksheet?
Medical professionals involved in the care of the patient are required to file the physical rehabilitation review worksheet.
How to fill out physical rehabilitation review worksheet?
The physical rehabilitation review worksheet should be filled out by documenting the patient's progress, current status, and future treatment plan.
What is the purpose of physical rehabilitation review worksheet?
The purpose of the physical rehabilitation review worksheet is to track the patient's rehabilitation progress and ensure that they are receiving appropriate care.
What information must be reported on physical rehabilitation review worksheet?
Information such as the patient's current physical abilities, limitations, treatment goals, and progress towards those goals must be reported on the physical rehabilitation review worksheet.
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