Physician Progress Note printable pdf download

Physician Progress Note Verbiage Examples

12.3.2014

WHEEL CHAIR

Hemi Height (<=5’6” or feet propels)

I evaluated (patient name) face to face for durable medical equipment. He/She needs a hemi height wheelchair

because of mobility limitations impairing their ability to participate in toileting, feeding, dressing, grooming,

bathing (MRADL’s) as noted in PT notes on Date and I concure with those PT notes.

Ex: unsteady gate due to weakness or neuropathy

Ex: Likely to fall because of distance to restroom, kitchen, etc

These ADL issues cannot be resolved by a cane or a walker and patient is willing and able to use a wheelchair

or has a caregiver to assist . The home is wheelchair accessible and the wheelchair will improve their ability to

perform toileting, feeding, dressing, grooming, bathing (MRADL’s). Ex: Will be able to ambulate from

bedroom to restroom and kitchen. Add other improvements in MRADLs because of the wheelchair specific to

this patient.

The seat height needs to be 17” – 18” because of short stature or will propel with their feet.

Light Weight

I evaluated (patient name) face to face for durable medical equipment. He/She needs a light weight wheelchair

with back and seat cushions because of upper body extremity muscle weakness and cannot propel a standard

wheel chair, but can propel a light weight wheelchair. Patient name has mobility limitations impairing their

ability to participate in toileting, feeding, dressing, grooming, bathing (MRADL’s) as noted in PT notes on Date

and I concure with those PT notes.

Ex: unsteady gate due to weakness or neuropathy

Ex: Likely to fall because of distance to restroom, kitchen, etc

These ADL issues cannot be resolved by a cane or a walker and patient is willing and able to use a wheelchair

or has a caregiver to assist. The home is wheelchair accessible and the wheelchair will improve their ability to

perform toileting, feeding, dressing, grooming, bathing (MRADL’s). Name of patient Ex: will be able to

ambulate from bedroom to restroom and kitchen. Add other improvements in MRADLs because of the

wheelchair specific to this patient.

Standard

I evaluated (patient name) face to face for durable medical equipment. He/She needs a standard wheelchair

with back and seat cushions because of mobility limitations impairing their ability to participate in toileting,

feeding, dressing, grooming, bathing (MRADL’s) as noted in PT notes on Date and I concure with those PT

notes.

Ex: unsteady gate due to weakness or neuropathy

Ex: Likely to fall because of distance to restroom, kitchen,

These ADL issues cannot be resolved by a cane or a walker and patient is willing and able to use a wheelchair

or has a caregiver to assist. The home is wheelchair accessible and the wheelchair will improve their ability to

perform toileting, feeding, dressing, grooming, bathing (MRADL’s). patient name Ex: will be able to ambulate

from bedroom to restroom and kitchen. Add other improvements in MRADLs because of the wheelchair

specific to this patient.

Heavy Duty (>=250lbs)

I evaluated (patient name) face to face for durable medical equipment. He/She needs a heavy duty wheelchair

because of mobility limitations impairing their ability to participate in toileting, feeding, dressing, grooming,

bathing (MRADL’s) as noted in PT notes on Date and I concure with those PT notes.

Ex: unsteady gate due to weakness or neuropathy

Ex: Likely to fall because of distance to restroom, kitchen, etc

Physician Progress Note

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