Transcription of Practitioner/Clinic Name: Body Map
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Example: biology
Practitioner/Clinic Name: Body Map
Practitioner/Clinic Name: _____ body Map Contact Information: _____. Name: _____ Date: _____. Note the finding next to the muscle checked: T = Tension, hypertonicity P = Pain S = Spasm I = Inflammation N = Numbness/tingling Arm Chest Neck Back Biceps/Tricep Supinator ____ Diaphragm ____ Scalenes Anter/Med/Post ____ Erector Spinae ____. Brachialis ____ Ext/Int Oblique ____ Splenus Capitus ____ Iliocostalis ____. Coracobrachialis ____ Intercostals ____ Splenus Cervicus ____ Infraspinatus ____. Deltoids: Ant/Lat/Post ____ Pectoralis Major/Minor ____ Sternocleidomastoid ____ Interspinalis ____. Pronator Teres ____ Rectus Abdominis ____ Supra Infra Hyoids ____ Intertransversarii ____.
Associated Bodywork & Massage Professionals MEMBER Practitioner/Clinic Name: _____ Body Map Contact Information: _____
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