Physical Therapy Initial Evaluation

[YOUR COMPANY NAME]

Date: [Date]

Patient Information

Medical History

Introduction

This evaluation will assess the patient's current condition and goals to develop an individualized treatment plan. It will facilitate our understanding of the patient's specific needs.

Overview

This comprehensive evaluation seeks to provide a structured and organized understanding of the patient's wellness objectives. It aims for an accurate assessment of their current physical performance to devise a suitable therapy plan.

Rating Scale

Ratings are based on a scale of 1 to 3, with 1 indicating inadequacy, 2 indicating moderate proficiency, and 3 indicating excellence in fulfilling the evaluation criteria. These ratings are relative and should be interpreted within the context of the specific evaluation criteria provided.

1 - Inadequate

• Signifies a minimal or insufficient level of performance.

• Indicates that the criteria are poorly addressed or not addressed at all.

• Demonstrates a lack of understanding, effort, or capability in fulfilling the evaluation criteria.

2 - Moderate Proficiency

• Represents a satisfactory but not exceptional level of performance.

• Shows some effort and competency in addressing the evaluation criteria.

• Indicates that the criteria are partially met or met to some extent, but with room for improvement.

3 - Excellent

• Reflects a high level of performance that surpasses expectations.

• Indicates thoroughness, accuracy, and effectiveness in fulfilling the evaluation criteria.

• Demonstrates a comprehensive understanding and proficient execution of the evaluation criteria.

Evaluation Criteria

Additional Comments and Notes:

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