Basic HTML Version
RP
Therapy
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Time In:
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Patient Name:
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Daily Physical Therapy Progress Note
Time Out:
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0 Parent/Guardian Initials to verify session time period
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Goals Addressed:
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Provider Signature
Parent/Guardian Signature
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Initials : My insurance information has not changed
�since my child's last therapy session.
Signature verifies that an RP Therapy Services, Inc. therapist provided
the services above and that services were provided in a satisfactory
manner.