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Prohab Studio Treatment Plan
Prohab Studio Treatment Plan
Client Name
*
First
Last
*
Last
Email
*
Condition ID
e.g. Regime number, injury condition
Todays Date
*
The purpose of the programme is to enable a return to -
*
Please choose one
Sport / leisure
Work
ADL’s
more detail
Expected recovery based on best estimate (% of preinjury capacity)
50
(% of preinjury capacity)
Time to expected recovery based on best estimate
Please choose one
0-3 months
3-6 months
6-9 months
9 -12 months
12-18 months
18 – 24 months
Relevant rehab considerations
Please choose one
No
Yes
e.g. Medical alerts, barriers to rehab, etc.
consideration
Programme structure & content
Please choose one
Prohab Studio Programme
Custom Designed Programme
type of Prohab programme
Please choose one
Total Gym Super 6
Prohab Studio General Strength
Custom Programme
Week 1&2
Custom Programme
Week 3&4
Custom Programme
Week 5&6
Programme Designer
Please choose one
Nigel Nairn
Cathy Grace
who built the programme
Studio Session Supervisor
Please choose one
Nigel Nairn
Cathy Grace
Other
Studio Session Supervisor
Who will deliver the programme in the studio
Studio Session Frequency
Please choose one
1 session per week
2 sessions per week
3 sessions per week
4 session per week
5 sessions per week
6 sessions per week
Daily
Studio Session Supervision Level
Please choose one
Fully supervised (1:1)
Semi-supervised (help available as required)
Self-directed (Trained first)
Programme Review Timeline
Week 1
Week 2
Week 3
Week 4
Week 5
Week 6
Includes – subjective & objective testing, then replanning.
Suggested Payment Plan
Please choose one
One off prepayment
Fortnightly prepayment
6 session prepaid concession card
Other
$ amount
General Comments
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