Complaint
Screen
Protocol
Note
Patient Complaint
Detailed complaint info drives the mode recommendation. The more specific, the better the output.
Patient Info
Primary Region
What Is the Primary Complaint? (tap all that apply)
Symptom Details
Contraindication Screen
All electrical stimulation modalities share these contraindications. Check ALL that apply.
๐ STOP โ Absolute Contraindication Present
Electrical stimulation is contraindicated. Do not proceed. Notify the treating provider.
โ ๏ธ Caution โ Use Only With Provider Clearance
Proceed only with specific provider order. Modify parameters as directed and document.
Absolute Contraindications โ All E-Stim Modes
Relative Contraindications / Precautions
Treatment Protocol
Mode recommended based on complaint intake. Tap any mode card to expand full parameters.
โ Mode โ
โก Electrode Placement
Application Instructions
Parameter Settings
Setup Reminders โ Forte 400
๐งด Skin prep: Clean skin with alcohol wipe. Dry thoroughly before electrode placement.
๐ Electrode spacing: Keep electrodes on same muscle group. Wider = deeper current path.
๐ Ramp up: Increase intensity slowly. Never jump to maximum โ patient discomfort = electrode issue or too fast.
๐ฌ Patient check: Sensory = comfortable tingling. Motor = visible twitch/contraction. Ask every 60 sec.
โฑ Standard time: 15โ20 min pain management. 10โ15 min muscle contraction modes.
๐ Stop if: Skin burns, increased pain, muscle cramp, skin color change, or patient distress.
Patient Response
Select what happened during treatment โ feeds into the note.
Well Tolerated
Full protocol, no issues
Sensory Level
Comfortable tingling reported
Motor Response
Good muscle contraction achieved
Intensity Reduced
Adjusted during session
Immediate Relief
Pain/spasm reduced post-tx
Stopped Early
Discomfort / poor tolerance
Clinical Note
Ready to copy into the EHR.
Colleyville Chiropractic
Electrical Stimulation โ Chattanooga Forte 400 Stim
Progress Note
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