Client Follow up Form + SOAP Report

Follow-up form

"*" indicates required fields

Client Follow up Form + SOAP Report

Date: 13/12/2025

Client's Name*

First name Last name

Date of visit

DD slash MM slash YYYY

Phone*

Health fund provider name*

"Other" health fund provider name*

Possible areas of soreness

Treatment Area / Areas of soreness*

Select area

Achilles Tendon

Back Deltoids

Back Forearms

Back Gastrocnemius

Back Gluteal Group

Back Hamstrings

Back Latissimus Dorsi

Back Trapezius

Back Triceps Brachii

Biceps Brachii

Brachialis

Brachioradialis

Coracobrachialis

Deltoid

Dorsal Interosseous Muscles

Erector Spinae

Flexor Carpi Radialis

Front Abdominal Muscles

Front Biceps Brachii

Front Deltoids

Front Forearms

Front Gastrocnemius

Front Pectoral Group

Front Quadriceps

Front Trapezius

Gastrocnemius

Gluteus Muscle

Hamstrings

Infraspinatus

Latissimus Dorsi

Levator Scapulae

Lumbrical Muscle

Masticatory Muscles

Muscles Of Foot

Muscles Of Hip

Muscles Of Leg

Muscles Of Thigh

Obliquus Abdominis

Occipitalis

Pectoralis Major

Pectoralis Minor

Piriformis

Plantar Interosseous Muscles

Plantaris

Popliteus

Quadratus Femoris

Quadratus Lumborum

Quadriceps Femoris

Rectus Abdominis

Rectus Femoris

Rhomboideus Major/Minor

Sartorius

Serratus

Soleus

Sternocleidomastoid

Subscapularis

Supraspinatus

Teres Major/ Minor

Triceps Brachii

Massage Technique*

Articulations Of Joint

Compression

Conduction (Heat Packs)

Cross Fiber Friction

Deep Gliding Friction

Deep Tissue Massage Techniques

Deep Transverse Friction

Dry Needling

Friction Techniques

Gliding Techniques

Leading

Manual Lymphatic Drainage

Myofascial Releasing Techniques

Myofascial Tension Technique

Passive Joint Movement Techniques

Passive Soft Tissue Movement

Percussion

Petrissage

Radiation

Soft Tissue Release

Stretching Techniques

Swedish

Topical Applications

Trigger Point Release Techniques

Trigger Point Therapy

Duration*

30 min

45 min

60 min

90 min

120 min

Client's Feedback

Alleviate Low – Back Pain And Improve Range Of Muscle

Blood Supply Stimulation

Body Rebalancing

Calming Of The Peripheral Nerves

Improve Flexibility And Muscle Condition

Increase Joint Flexibility

Joint Mobility

Lessen Depression And Anxiety

Muscle Not As Tight As Before

Muscle Strengthening

Pain Reduction

Reduce Pain And Swelling

Reduce Spasms And Cramping

Relax And Soften Injured, Tired, And Overused

Relaxation Skin Nourishment

Relieve Migraine Pain

Remove Stiffness

Swelling Reduction

Toxin Cleaning

Recommendations

Therapist's Name*

Practitioner