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Patient:Ins Co:WA MEDICARE-NORIDIAN Pol #:NONE DOB: 0Acct #: <br />Date 07/29/2025Provider:Mark Shelley, DC, DACNB <br />Chart Notes 6603 220th St. SW Suite 102Mountlake Terrace, WA 98043-2186Phone: (425) 774-2411Fax: (425) 672-7065 <br />Olympic Spine and Sports Therapy <br />Subjective: (Per 1997 Evaluation & Management Guidelines) <br />Patient History: <br />CC: Male who presented on 7/29/2025 for a new patient evaluation for the symptoms listed below. <br />History of Present Illness:Symptom #1: Right Hip Pain Severity (0-10, 10=worst): 5/10Symptom #2: Low Back Pain Severity (0-10, 10=worst): 5/10Symptom #3: Right Anterior Lateral Thigh Pain Severity (0-10, 10=worst): 5/10 <br />Onset: 3 months agoHow often do you have this pain? DailyIs it constant or does it come and go? constantIs condition getting progressively worse? NoDoes the pain radiate ("shooting down" or "shooting up")? Yes - down right leg Quality: Achy and StiffnessWhat makes your condition worse? BendingWhat makes your condition better? Rest and HeatWhat time of day are symptoms worse? no differenceWhat time of day are symptoms better? no differenceIs there any known cause of your symptoms? "old age"Is there any color change or temperature change to the skin? No When your symptoms are at worst, describe what happens: Weakness in right legHave you experienced symptoms like these before? NoHave you missed any work due to this condition? No - retiredHave you had to modify or restrict your activities at work? No - retired <br />Past Medical, Family & Social History: Avg sleep per night:8 hours How often do you wake up at night? 1 times Are you awakened due to pain? times Smoking:NeverCaffeine drinks:1 cup per dayAlcohol:2 cups per dayExercise:4 times per week (type: yardwork) Stress Level:2 (0=no stress, 10=max stress) <br />Printed:Page 1 Of 7Tuesday, August 12, 2025 4:16:38 PM