Spinal cord injury
(D1)
Neuromuscular
(D2)
Poliomyelitis
(D3)
Erbs Palsy
(D4)
Spastic Quadriplegia
(D6)
Spastic Diplegia
(D7)
Low tone CP
(D8)
Inuit Exercises
(useful local treatment)
(not yet done)
Developmental delay
(D5)
Hemiplegia
(D9)
Dyskinetic
(D10)
Ataxia
(D11)
Suspected spinal tumour
(D12)
(from my own observations of my patient)
- Patient Name:...
- Patient address & phone number:...
- My patient needs to be referred to:...
- I need to get an assistive aid (tripod, stick, crutches, heel raise etc):...
- Next review date:...
- I need to clinically review:...
- I want to focus on treatment number:...