Physical Therapy Progress Note Template

Patient Name:
Date / Time:
Visit Number:

Subjective:
- Patient Report:
- Pain Level (Pre/Post):
- Compliance with Home Program:

Objective:
- Therapeutic Exercises:
- Manual Therapy:
- Modalities:
- Functional Measurements:

Assessment:
- Response to Treatment:
- Progress Toward Goals:
- Barriers/Limitations:

Plan:
- Next Session Interventions:
- Home Exercise Updates:
- Recommendations/Referrals:

Sign-off:
- Therapist Signature  Credentials
- Date / Time