Free Personal Injury Cases Doctor Note Template
Personal Injury Cases Doctor Note
Patient Information
Name: Michael Smith
Date of Birth: January 15, 2050
Address: 456 Maple Ave., Sunnyvale, CA 94086
Phone Number: (555) 987-6543
To Whom It May Concern,
This letter is to confirm that I, Dr. [Your Name], examined Michael Smith on October 1, 2055. The patient was referred to my office due to injuries sustained in a motor vehicle accident on September 28, 2090.
Findings:
Upon examination, the following injuries were noted:
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Whiplash: Causing neck pain and stiffness.
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Contusion on Right Knee: Resulting in bruising and swelling.
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Back Strain: Mild discomfort and limited range of motion.
Treatment Plan:
The patient has been advised to follow the treatment plan outlined below:
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Physical Therapy: Twice a week for 6 weeks to address neck and back pain.
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Pain Management: Over-the-counter pain relievers, such as ibuprofen, as needed.
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Ice Therapy: Apply ice to the knee for 15-20 minutes every 2-3 hours to reduce swelling.
Prognosis:
The prognosis for recovery is favorable with appropriate treatment. However, the patient may require follow-up appointments to monitor recovery and adjust the treatment plan as necessary.
Work/Activity Restrictions:
As a result of the injuries sustained, I recommend the following activity restrictions:
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No heavy lifting over 20 pounds.
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Limit standing or walking for extended periods (more than 30 minutes).
Next Appointment:
The patient is scheduled for a follow-up appointment on October 15, 2090.
If you require any additional information, please feel free to contact my office.
Sincerely,
Dr. [Your Name], MD
Board Certified in Orthopedic Surgery
