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Patient # PHYSICAL THERAPY INITIAL EVALUATION FORM PATIENT INFORMATIONAL NAME (LAST) (FIRST) (MIDDLE INITIAL) SOCIAL SECURITY NUMBER DOB AGE HEIGHT WEIGHT HOME PHONE () CELL (ARE YOU CURRENT WORKINGS)

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How to fill out shoulder pain - arthritis

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To fill out the form for shoulder pain - arthritis, follow these steps:

02

Start by providing your personal information such as name, age, and contact details.

03

Mention the duration of your shoulder pain, whether it is acute or chronic.

04

Describe the intensity of the pain on a scale of 1 to 10, with 10 being the highest.

05

Specify any previous medical treatments or therapies you have undergone for shoulder pain.

06

Indicate any medications you are currently taking for arthritis or shoulder pain management.

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Explain any triggers or factors that worsen your shoulder pain, such as specific activities or movements.

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Provide details about any additional symptoms you experience along with shoulder pain, such as swelling or difficulty in movement.

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If you have received a diagnosis for arthritis, mention the type of arthritis you have been diagnosed with.

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Include any relevant medical history or pre-existing conditions that may contribute to your shoulder pain or arthritis.

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Finally, review all the information you have provided and make sure it is accurate before submitting the form.

Who needs shoulder pain - arthritis?

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Shoulder pain - arthritis is needed by individuals who experience ongoing shoulder pain and have been diagnosed with arthritis.

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This form is suitable for people who want to document their shoulder pain symptoms and provide detailed information to healthcare professionals.

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It can be used by patients seeking medical advice, treatment, or those participating in research studies related to shoulder pain and arthritis.

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What is shoulder pain - arthritis?

Shoulder pain - arthritis is a condition that causes inflammation and pain in the shoulder joint.

Who is required to file shoulder pain - arthritis?

Patients experiencing shoulder pain - arthritis may be required to report it to their healthcare provider.

How to fill out shoulder pain - arthritis?

Patients can fill out a shoulder pain - arthritis form provided by their healthcare provider with details of their symptoms and medical history.

What is the purpose of shoulder pain - arthritis?

The purpose of reporting shoulder pain - arthritis is to help healthcare providers diagnose and treat the condition effectively.

What information must be reported on shoulder pain - arthritis?

Patients may need to report details of their symptoms, duration of pain, any previous injuries, and medical history.

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