Transcription of PT Evaluation / Reevaluation - Kinnser Software
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PT Evaluation / Reevaluation - Kinnser Software
PT Evaluation / Re evaluationPage 1 of 4PT Evaluation / Re evaluationClinician:MOnsetExacerbationPa tient identity confirmed by clinicianFROM/StrengthResidual weaknessNo hazards identifiedSteps/stairsInadequate lighting, heating and/or coolingInsect/rodent infestationNo gas/electric applianceNarrow or obstructed walkwayCluttered/soiled living areaNo running water, plumbingLack of fire safety devicesOther(specify):Needs assistance for all activitiesRequires max assistance/taxing effort to leave homeUnable to safely leave home unattendedSevere SOB, SOB upon exertionConfusion, unsafe to go out of home aloneBalance/GaitPainSafety TechniquesTransferBed MobilityW/C MobilityPatient Name (Last Name, First Name) & MRN:Date:Time In:Time Out:DOB:Associated mileage:milesGender:Agency Name/Branch:Diagnosis/HistorySocial Supports / Safety HazardsMedical Diagnosis:Date:OnsetExacerbationPT Diagnosis:Prior Level of Functioning:Comments:Other:Functional Limitations:Homebound?
PT Evaluation / Reevaluation PT Evaluation / Reevaluation Page 1 of 4 Clinician: M Onset Exacerbation Patient identity confirmed by clinician F ROM/Strength
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