Mary Bruce

 Unity Medical Center
 Mary Bruce 
 MRN: 33773659, dob: 04-20-1994, Sex: M 
 02985 Amy Lane Suite 404
Port Michele, NY 27337
 Visit Day: 07-25-2016 
 Result Summary (continued) 
 Documents - Encounter Level on 01-17-2022: (continued) 
 Dr Christopher Patterson, MD 
 Phone: 332-136-3811 
 02985 Amy Lane Suite 404
Port Michele, NY 27337
 Please sign and return this page only by fax or mail. 
 Plan of Care Approval for Mary Bruce 
 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: 
 Adam Clark, PT, DPT PT60388818 
 02-14-2017 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 Christopher Patterson, MD 
 Approval Date: 
 04-16-2017 
 Progress Evaluation for Mary Bruce 
 Page 6 
 dob: 04-20-1994
