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Travis G. Maak, M.D. 590 Wakara Way Salt Lake City, UT 84108 Tel: (801) 5877109 Fax: (801)5877112Lic. # 82347971205Physical Therapy Prescription Tibial Tubercle Osteotomy Todays Date:Patient Name:Dx:
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How to fill out physical formrapy prescription acl

01
Obtain the physical therapy prescription form from the healthcare provider.
02
Fill out the patient's personal information, including name, date of birth, and contact information.
03
Specify the diagnosis or reason for the physical therapy referral.
04
Indicate the frequency and duration of the prescribed physical therapy sessions.
05
Include any specific instructions or restrictions for the physical therapist.
06
Sign and date the prescription form to authorize the physical therapy treatment.

Who needs physical formrapy prescription acl?

01
Individuals who have been diagnosed with an ACL injury or related knee condition.
02
Patients who have undergone surgery or other medical interventions for ACL repair.
03
Athletes or active individuals seeking rehabilitation and recovery after an ACL injury.
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A physical therapy prescription ACL refers to a document that outlines the need for physical therapy specifically for individuals recovering from an anterior cruciate ligament (ACL) injury, detailing the treatment plan and frequency of sessions.
Typically, healthcare providers, such as physicians or licensed physical therapists, are required to file a physical therapy prescription for ACL treatment on behalf of their patients.
To fill out a physical therapy prescription for ACL injuries, healthcare providers must include patient information, diagnosis, treatment goals, recommended frequency and duration of therapy sessions, and their signature.
The purpose of a physical therapy prescription for ACL is to formally document and authorize the need for physical therapy interventions to aid recovery from an ACL injury.
Information that must be reported includes the patient's personal information, diagnosis, specific treatment plan, type of services required, and the referring provider's information.
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