Megan Newman

 C Oct 22, 2015 3:31 PM 585-745-8137 62070405274 pg 2 of 7 
 CLIENT: Megan Newman 
 CLAIM 
 DOS: May 16, 2014 
 
 The patient appears motivated. Patient consents to treatment plan and goals 
 and gives verbal informed consent. 
 
 Goals Time Result Comment Frame 
 100% compliance to HEP In progress 
 At least 10% reduction in Quick DASH In progress 
 
 Dr John Young DPT This document was electronically signed on May 05, 2021 at 03:29p by Dr John Young DPT. 
 
 Patient: Megan Newman Claim#: 
 26144 Pitts Haven Apt. 846
Jenniferhaven, FL 64869 Phone: 585-745-8137 
 Fax: 267-736-4661 
 WWW.NWRTW.COM 2 OF 5 
 9-9-2019 301620704052741 522019080548302
