Chiropractic Soap Note

SOAP Note

The following document has been prepared by Patricia D. Adams, a medical professional at Quantum Leap Innovations. This is a standardized SOAP (Subjective, Objective, Assessment, Plan) note for intended use by chiropractic practitioners. Utilizing this SOAP note helps ensure the provision of thorough yet concise patient evaluations, whilst maintaining an optimally formatted and professional presentation.

Abbreviation	Description
Subjective	Patient: Daniel Taylor Age: 38 years Sex: Male Height: 6'2" Weight: 200 lbs Health History: Non-smoker, moderate physical activity, no known heart conditions
Objective	Body Posture: Poor, indicating potential musculoskeletal issues Pain and Discomfort: Reports recurrent lower back pain Mobility: Displays limited range of motion due to discomfort Vital signs: Within normal ranges
Assessment	The patient's recurrent lower back pain combined with mobility limitations suggest the possibility of a lumbar musculoskeletal disorder. Further diagnostic evaluations are advised to confirm this preliminary assessment.
Plan	Diagnostic Tests: Order radiographic imaging to evaluate lumbar spine structure Interventions: Recommend chiropractic adjustments and physiotherapy if diagnosis confirmed Follow-up: Schedule for two weeks from now to assess the outcome of interventions

Date of completion: 21st February, 2050.