Peggy Quinn
 
 
 onecall care 
 PHYSICAL THERAPY 
 FAX / EMAIL Confidential - 4/12/2019 6:39:40 PM 
 DISCHARGE / DISCONTINUATION SUMMARY 
 PLEASE FAX TO (904) 309-8942 
 Re: Injured Worker: EDWARD FOSTER 
 Claim Number: 
 PZC29924294 
 Initial Eval Date: 2018/11/10
 Employer: 
 SUPER STORE INDUSTRIES; MID 
 Referring Physician: Jenny Wong 
 Facility Name: 
 Tower Physical Therapy 
 Service Type: 
 Physical Therapy 
 INJURY DATE: 
 2022/26/04 
 Total Visits: 
 No 
 Shows/Cancellations: 
 Pain Rating: (please choose from 0, 1, 2, 3, 4, 5, 6, 7,8, 9, 10) 
 / 10 
 At Initial: 
 At Discharge: 
 / 10 
 Thank you for choosing One Call Physical Therapy. Visit us on the web at 
 www.onecallcm.com 
 000121 
 0121 
 TAG:12-EMBID-4764913: 
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