Crystal Landry

 Downtown Medical Center
 Crystal Landry 
 MRN: 33773659, date of birth: 08/97/04, Sex: M 
 7604 Lauren Village
Justinstad, TN 92428
 visiting date: 04/18/12 
 Result Summary (continued) 
 Documents - Encounter Level on 16/15/03: (continued) 
 Dr Frank Burns, MD 
 Phone: 714-503-6269 
 7604 Lauren Village
Justinstad, TN 92428
 Please sign and return this page only by fax or mail. 
 Plan of Care Approval for Crystal Landry 
 Thank you for this referral. 
 Dean Harm is a good candidate for continued physical therapy services. Patient has been compliant to 
 home exercise program.
 Respectfully yours, 
 Therapist Signature: 
 David Gonzales, PT, DPT PT60388818 
 03/15/06 9:13 pm 
 Plan of Care Approval 
 Total Visit Count: 5 
 Approval of the plan of care as documented 
 Changes to Plan of Care: 
 Hold therapy service until patient follows up at physician office. 
 Physician Signature: 
 Dr Frank Burns, MD 
 Approval Date: 
 16/18/01 
 Progress Evaluation for Crystal Landry 
 Page 6 
 date of birth: 08/97/04
