Emily Gonzalez

00022 
 Willowbrook Clinic 
 34340 Simmons Grove
Holmestown, ME 41561 
 Tel: 661-926-7943 
 Willowbrook Clinic 
 Fax: 286-478-7818 
 www.landswickpt.com 
 PHYSICAL THERAPY. INC. 
 Quick SOAP 
 Patient (ID 1 D.O.B): Emily Gonzalez (cazaresa I 09 May 1998) 
 Treatment Date: 13 Apr 2023 11:30 AM 
 Insurance: 
 Gallagher Bassett Services - California 
 Visits: 
 2 
 Episode: 
 R elbow 
 Re-Eval Due: 
 Referrer: 
 Dr Sydney Mckee MD 
 Next Follow-up: 
 Diagnosis Codes: 
 Asthma (K35), HIV/AIDS (G35), Ulcerative Colitis (E11)
 SOAP 
 Subjective 
 Pt reports that she was a little sore after last session.
 Objective 
 Tx: STM triceps, wrist extensors, wrist supinators, biceps; CFM along medial and lateral epicondyles; 
 Plan 
 Cont per POC. 
 EXERCISE FLOWSHEET 
 See hard copy for list of exercises. 
 CHARGESHEET 
 Time Information 
 Total Direct Time 
 30 Minutes 
 Billing Codes 
 Code 
 Description 
 Units 
 Comments 
 78606 
 Joint Mob/STM/Manual Therapy 
 2 
 Electronically Signed by: Amanda Jordan DDS, PT, DPT (Random_7_digit_number) 
 Date: 18 Aug 2021 
 (This document was electronically signed on 18 Aug 2021 by Amanda Jordan DDS) 
 Note written with MWTherapy I Patient ID/Patient (D.O.B): cazaresa/Emily Gonzalez (09 May 1998) I dos: 29 Dec 2017 11:30 AM 
 Page 1 of 1 
 78606 
 46647989028 
 Received 30 Apr 2016
