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Intake demographics, treatment goals, and a contraindication screening.

Demographics

Patient details

Full name*

Date of birth

Phone

Intake

Goals & notes

Goals / conditions

Practitioner notes

Screening

Contraindication checklist

Check anything the patient currently presents. Any check flags the record as screening required and blocks session logging until cleared.

Acute inflammation, phlebitis, or thrombosis

Active DVT, superficial phlebitis, or unresolved acute inflammation.

Active infection or open ulcers

Skin infections, cellulitis, open wounds, or pressure ulcers in treatment area.

Pregnancy

Any trimester. Defer to OB clearance before scheduling.

Recent or unhealed fracture

Fracture in treatment area within the last 6 weeks or not radiographically healed.

Congestive heart failure (CHF)

Decompensated CHF or fluid-overload risk.

Severe COPD

Severe or unstable chronic obstructive pulmonary disease.

Significant vascular disease

Severe peripheral arterial disease, aneurysm, or unstable vascular condition.

Patient may proceed to session logging after intake is saved.