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Henry Ford Health System 6777 W. Maple Rd., West Bloomfield, MI 48322 2825 Liverpool, Troy, MI 48083 pH: 2486617029 www.ericmakhnimd.com PHYSICAL THERAPY PROTOCOL/PRESCRIPTION: SMALL/MEDIUM ARTHROSCOPIC
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How to fill out physical formrapy protocolprescription

01
To fill out a physical therapy protocol prescription form, follow these steps:
02
Start by filling out the patient's personal information, including their name, address, phone number, and date of birth.
03
Indicate the referring physician or healthcare provider by providing their name, address, and contact information.
04
Specify the diagnosis or medical condition for which physical therapy is being prescribed.
05
Describe any relevant medical history or current medications that may affect the prescribed therapy.
06
Outline the specific goals and objectives of the physical therapy treatment.
07
Indicate the frequency and duration of the prescribed therapy sessions.
08
Provide any additional instructions or special considerations for the physical therapist.
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Finally, sign and date the prescription form before submitting it to the physical therapy provider.

Who needs physical formrapy protocolprescription?

01
Physical therapy protocol prescriptions are typically needed for patients who require physical therapy as part of their treatment plan.
02
These patients may include those recovering from surgery, individuals with chronic pain or musculoskeletal disorders, athletes rehabilitating from sports injuries, or individuals with mobility or balance issues.
03
The prescription ensures that the physical therapist has all the necessary information to develop a tailored treatment plan and provide appropriate care.
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Physical therapy protocol/prescription is a written plan developed by a licensed healthcare provider that outlines the specific physical therapy treatments a patient requires.
A licensed healthcare provider, such as a physician or a physical therapist, is required to file physical therapy protocol/prescription for their patients.
Physical therapy protocol/prescription can be filled out by the healthcare provider by detailing the patient's diagnosis, treatment goals, frequency and duration of therapy sessions, and any specific exercises or modalities prescribed.
The purpose of physical therapy protocol/prescription is to guide the physical therapist in providing appropriate treatments and interventions to help the patient recover from their injury or condition.
Physical therapy protocol/prescription must include the patient's personal information, diagnosis, treatment plan, and any specific instructions for therapy sessions.
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