SOAP Acupuncture SOAP Acupuncture Treatment Date* MM slash DD slash YYYY Patient Name* First Last Patient's Date of Birth* MM slash DD slash YYYY SubjectiveList Primary Complaints and if they are improving, deteriorating, no change or 1st visit:*Pain scale 0 (None) -10 (High) and Type of pain?ObjectiveNotes*Therapies Performed Today* Acupuncture 1st set of needles CPT 97810 Acupuncture 2nd set of needles CPT 97811 Acupuncture 3rd set of needles CPT 97812 Electrical Stim 1st set of needles CPT 97813 Electrical Stim 2nd set of needles CPT 97814 Electrical Stim 3rd set of needles CPT 97815 Cupping CPT 97016 Manual Therapy CPT 97140 Infrared Heat CPT 97026 Moxabustion or Other Therapy (please explain) CPT 97039 Injection Therapy CPT 20552 Total time spent with patient*Acupuncture Point Descriptions*Manual Therapy Description*Assessment and PrognosisNotesPain scale 0 (None) -10 (High) and Type of pain?Post Treatment Patient Subjective CommentsPlanNotesProvider Name* First Last Credentials
