Cynthia Ryan

 16/21/07 10:08:03 EDT 
 To: 18003806151 
 Page: 24/33 
 From: 8332845756 
 Fax: 8332845756 
 Initial Evaluation Note 
 Patient: 
 Cynthia Ryan
 BIRTHDATE: 
 06/97/04
 Sex: F 
 Visit Day: 
 16/17/02
 Visit # 1 
 Provider: 
 Brandon Bensing 
 NPI # 1225662943 
 Clinic Details 
 Case Details 
 Clinic 
 Address 
 Injury Description 
 Injury Onset Date 
 Willowbrook Clinic 
 4125 Dick Pond Road 
 Back Pain 
 16/21/07 
 Phone # 
 Myrtle Beach, SC 29588-6807 
 Diagnosis Codes 
 G35 
 Fax # 
 8332845756 
 Referring Physician 
 Ashley Maybin 
 Subjective Analysis 
 Previous History of Symptoms 
 YES 
 Patient Chief Complaint 
 Patient Goals 
 Patient Problem List 
 Patient suffers from or currently has Atrial Fibrillation
 Thyroid problems, Arthritis, Other orthopedic problems, 
 Osteporosis, Chronic pain, Chronic migraines  
 Treated by Dr Jeffery Butler (License #10144) 
 dos: 11/18/09
 Page 1 of 6 of Initial Evaluation Note
 