Jo White

 
 North County Physical Therapy 
 17815 Countryside Ct 
 Physical Therapy 
 Prunedale, CA 93777-8804 
 Initial 
 Phone: (831)774-5779 
 Fax: (831)663-7722 
 Examination 
 Patient name: Jo White 
 Date of Initial Examination: 09-01-2016 
 date of birth: 12-22-1993 
 Injury/Onset/Change of Status Date: 07-17-2014
 Referring Physician(s): Dr Dawn Caldwell MD 
 Diagnosis: ICD10: S32.2XXA: Pulmonary Embolism
 Visit No.: 1 
 Treatment Diagnosis: ICD10: S32.2XXA: Pneumonia, 
 Subjective 
 History of Present Condition/Mechanism of Injury: Patient states she did not fracture her coccyx although that is her official 
 diagnosis on the Worker's Comp. forms. 
 Pain Location: Left SI 
 Pain Scale: Worst: 8 Best: 3 Current: 5 
 Pain Description: Sharp 
 Medical History: No Known Significant PMH To Affect Treatment 
 Objective 
 Inspection 
 Patient Consent 
 Patient/Parent/Guardian Consent 
 Yes  
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 GB IA Recv 2022121920739 
 Received 12/19/2022
