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Unformatted text preview: Pos Neg Balanced Fluid Motion: L R Sacral leg check: L R Neg Supine Leg Check: Short L R Amount _____ Even X-ray Listings : Leg AD: L_____ R_____ None X-rays Date: Occiput: Atlas: Lower Cervical: Thoracic: Lumbar: Ilium: L_____ R_____ Sacrum: Assessment: Recommendations: Adjustment: Segment Listing Technique Post Checks: I understand that care is not being provided, but the adjustment is being performed in a classroom setting strictly as a learning experience and with potentially incomplete work-up. It is not the intention of this encounter to be therapeutic. Patient: Date: Student Doctor: Date: Observing Doctor: Date:...
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- Fall '11