Acupuncture Session Tracker

Session Date:

Session Time:

I. Patient Assessment

II. Treatment Planning

III. Live Treatment

I. Patient Assessment

Primary Constitutional Type:

Secondary Type:

Symptom Categories: Hold Ctrl/Cmd to select multiple categories

Detailed Symptom Description:

Tongue Assessment

Observe tongue for no more than 20 seconds. Look from tip to back, then sides.

Tongue Body Color:

Tongue Coating:

Tongue Texture:

Tongue Movement:

Tongue Tip (Heart/Emotional state):

Tongue Sides (Liver/Gallbladder):

Additional Tongue Observations:

Pulse Diagnosis

Left Hand Pulse Positions

Cun Superficial (Small Intestine):

Cun Middle (Heart):

Cun Deep (Heart):

Guan Superficial (Gallbladder):

Guan Middle (Liver):

Guan Deep (Liver):

Chi Superficial (Bladder):

Chi Middle (Kidney):

Chi Deep (Kidney):

Right Hand Pulse Positions

Cun Superficial (Large Intestine):

Cun Middle (Stomach):

Cun Deep (Lung):

Guan Superficial (Stomach):

Guan Middle (Spleen):

Guan Deep (Spleen):

Chi Superficial (Triple Warmer):

Chi Middle (Pericardium):

Chi Deep (Pericardium):

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Session Notes:

II. Treatment Planning

Treatment planning section - to be implemented

III. Live Treatment

Live treatment tracking section - to be implemented

Five Element Acupuncture Practice

I. Patient Assessment

Tongue Assessment

Pulse Diagnosis

Left Hand Pulse Positions

Right Hand Pulse Positions

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II. Treatment Planning

III. Live Treatment

Saved Assessment Sessions