This section was compiled by Frank M. Painter, D.C. Send all comments or additions to:Frankp@chiro.org
This page is devoted to a full description of what is considered “complete” patient file documentation, as described by National Associations and Third party Payors. It is the intention of this page to inform our profession of the most efficient means of communicating patient information, as well as outlining what is considered adequate documentation.
Vertebral Subluxation in Chiropractic Practice
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Chiropractic Examination starts on page 55 of 318.
Guidelines for Chiropractic Quality Assurance and Practice Parameters
a.k.a. The Mercy Conference Refer to Section I
Chapter 1: Documentation Recommendations
Initial New Patient History: Subjective
Wisconsin Chiropractic Association
This section forms the objective area of clinical documentation. The complexity of the patient’s health problems will determine which of these elements a chiropractor will choose to use in the patient’s record. A chiropractor’s records detailing problems of greater severity will generally include more of these elements. It may not be necessary to include many of these elements in the records of patients with less severe problems.