# Chiropractic Practice Blueprint Keep the mentor’s process intact. Turn each instruction into a visible obligation, give the right person the original script at the moment of work, and keep every unresolved patient or staff dependency on a queue until it is resolved. This is a reviewable proposal, not an operating patient system. The only software built now is this read-only proposal website and its local demonstration. There are no patient records, outbound messages, live calendars, clinical decisions or background follow-up workers in this application. Chiropractic is an independent product and operating domain. The home-service system was inspected as a read-only design reference. No sales-system source, configuration, pipeline, worker or customer record is changed. Future implementation gets its own codebase, deployment, data, integrations and credentials; it does not run under Sales Operations. ## Research coverage { "photos": 166, "workflows": 150, "scripts": 105, "obligations": 990, "findings": 52, "date": "2026-10-02", "mode": "proposal-only", "source": "Mentor-provided chiropractic playbook photographs", "transcription": "gpt-6-luna plus Apple Vision OCR comparison, all pages reviewed; 14 close-image reviews and targeted manual visual checks. OCR agreement is not an accuracy guarantee.", "dispositions": { "mapped": 146, "reference": 6, "duplicate": 14 } } ## Proposed patient pipeline ### Inquiry / referral received Entry: A person calls, submits an inquiry, is referred, or responds to a campaign. Owner: Reception Exit evidence: Identity, contact preference, referral source, new/existing status and the next action are recorded. - Existing active patient → appropriate appointment. - Inactive patient → return consultation branch. - Questions or hesitation → named callback or Room 4-style concern task; no invented endless cadence. Workflows: rec-phone-coverage, rec-inbound-booking, care-primary-booking, grow-prospect-discovery, grow-new-patient-booking, rec-marketing-call ### Day 1 scheduled Entry: The patient accepts a specific first-visit time. Owner: Reception Exit evidence: Appointment exists; directions and preparatory requirements are delivered; arrival is recorded. - Cancellation/reschedule replaces old appointment reminders. - No arrival opens the Day 1 recovery path. - Accident or work injury opens a parallel financial/claim track. Workflows: rec-calendar, rec-reminders, rec-missed-onboarding, rec-day1-frontdesk, grow-day1-reminder, grow-day1-missed, care-marketing-reminder ### Day 1 / initial evaluation Entry: Patient arrives for consultation and examination. Owner: Enrollment + Doctor Exit evidence: Intake and consent documented; clinician completes evaluation; clinical handoff and next visit are explicitly set. - Urgent concern or unsuitable care → clinician-directed route. - Incomplete forms, records or financial facts → visible dependency. - No automatic diagnosis, treatment recommendation or imaging order. Workflows: rec-arrival, rec-day1-frontdesk, rec-day1-consult, rec-policies-consent, rec-doctor-calls, care-day-one, grow-day1, care-day-one-fees, care-weak-day-one, care-visit-documentation ### Report of Findings scheduled Entry: The clinician has a findings discussion to conduct. Owner: Enrollment Exit evidence: Required clinical and financial preparation is complete; attendance and support-person arrangements resolved. - Group ROF / private ROF / Mini Day 2 are explicit variants. - Missed ROF gets its own script and recovery workflow. - A missing support person is discussed, never a forced care condition. Workflows: rec-rof-preparation, rec-rof-invitation, rec-mini-day2, care-rof-booking, care-mini-day-two, grow-day2-followthrough ### Findings / options discussed Entry: Patient attends the Report of Findings. Owner: Doctor + Enrollment Exit evidence: Findings explained; questions and voluntary care preference recorded; financial options and next action documented. - Proceed → Day 3 / active care after clinical authorization. - Three-visit trial → trial review obligation. - Undecided / financial concern → private follow-through. - Decline → respectful closure with clinician-directed continuity. Workflows: rec-group-rof, rec-private-rof, rec-financial-options, care-orientation-rof, grow-day2, grow-financial, care-enrollment-barrier, care-trial-care, care-distance-barrier ### Day 3 / orientation Entry: Patient returns after the initial findings discussion. Owner: Enrollment + Reception Exit evidence: Orientation, scheduling, education and unresolved enrollment items are complete or have named owners. - Family follow-through, financial questions and trial decisions remain independent tasks. - A missing orientation action cannot disappear because a visit was billed. Workflows: rec-day3, rec-three-visit-review, rec-quality-fileflow, rec-checkout, grow-day3, grow-day3-missed, care-family-check, rec-family-invitation ### Active care / every visit Entry: A clinician-authorized plan is active. Owner: Doctor + Reception Exit evidence: Every visit has attendance, clinical documentation, financial recording and a next appointment or intentional disposition. - Missed / late / cancelled visit opens recovery without overwriting the care plan. - New symptom or concern goes to the clinician. - No next appointment becomes an exception, not an invisible exit. Workflows: rec-arrival, rec-checkout, rec-calendar, rec-doctor-delivery, rec-education, care-visit-loop, care-first-adjustment, care-first-adjustment-call, care-adverse-response, care-no-adjustment, care-technique-record, care-rehab-adherence, rec-rehab-handoff, grow-travel-card ### Seventh visit / progress checkpoint Entry: The seventh completed visit in the applicable source pathway. Owner: Enrollment + Doctor Exit evidence: Progress is explicitly checked; concerns reach the doctor; an appropriate referral invitation is recorded. - Label remaining severity versus improvement clearly; the photographed scoring convention can be inverted. - Unfavorable progress creates a clinician review rather than a marketing prompt. Workflows: grow-visit7, care-at-risk, rec-room4 ### Re-exam due / progress review Entry: The book’s visit-count review threshold is reached; clinician confirms applicability. Owner: Doctor + Enrollment Exit evidence: Re-exam and progress discussion documented; next plan, schedule and financial dependencies updated. - The source gives a 12-visit review; the software counts completed visits, not reservations. - Overdue review remains visible while staff route the patient. - A changed plan cancels superseded obligations only with explicit replacement. Workflows: rec-reexam, care-re-exam, grow-reexam ### Re-report / care-plan renewal Entry: The source’s repeat review milestone or a clinician-directed reassessment is due. Owner: Doctor + Enrollment Exit evidence: Clinician documents the review and care decision; renewed or changed schedule and financial arrangement recorded. - 24–36 visit language and “before the 35th” require a policy decision. - Imaging is a clinician decision, not a timer-triggered order. - Relief, corrective and supportive paths remain distinct. Workflows: rec-rereport, rec-financial-options, care-comparison-imaging, care-re-report, grow-rereport, rec-plan-end-review ### Continuing / supportive care Entry: The patient and clinician choose the appropriate continuing pathway. Owner: Doctor + Reception Exit evidence: Current schedule, periodic reviews and patient preference remain explicit. - Lower-frequency appointment reminders use the book’s applicable branch. - Education and community programs are optional parallel activities. - A new episode opens a linked episode rather than erasing history. Workflows: rec-calendar, rec-education, rec-reminders, care-relief-path, care-weekly-rhythm, grow-internal-education, grow-advanced-talk ### Inactive / recall / reactivation Entry: The patient leaves the active schedule, misses care, or is selected by the source recall process. Owner: Reception + Doctor Exit evidence: Reason is recorded and resolved to rebooked, future callback, declined, unreachable with approved next review, or clinician action. - Rapid missed-visit recovery is not the same as monthly inactive recall. - Weekly versus monthly routing uses source frequency classes. - Reactivation campaigns do not override an existing recovery call or contact restriction. Workflows: rec-missed-visit, rec-recall-lists, rec-reactivation, rec-inactive-return, care-inactive-recall, care-returning-inactive, grow-inactive-checkin, grow-regular-missed, grow-inactive-return, grow-qc-exit ### Resolved / transferred / declined Entry: A documented patient choice or clinician-directed disposition closes the current episode. Owner: Doctor + Reception Exit evidence: Reason, remaining obligations and allowed future contact are explicit; open clinical/financial duties are not silently discarded. - Stop routine outreach when permission is withdrawn. - Preserve the record and approved continuity steps. - A future return creates a reviewed transition, not automatic replay of Day 1 marketing. Workflows: rec-discontinuation, care-departure, grow-qc-exit ## Parallel tracks ### Attendance & recovery ['Scheduled', 'Confirmed', 'Arrived', 'Completed', 'Late / absent', 'Recovery due', 'Rebooked', 'Recall / clinician review'] Booking, confirmation, arrival and completed care are different events. A reschedule invalidates the old timers. ['rec-missed-visit', 'rec-missed-onboarding', 'rec-recall-lists', 'rec-reminders', 'grow-regular-missed', 'grow-day1-missed', 'grow-day2-followthrough', 'grow-day3-missed', 'care-calendar-change', 'care-marketing-recall'] ### Clinical follow-through & concern escalation ['Clinician event recorded', 'Follow-up assigned', 'Attempted', 'Response reviewed', 'Clinical decision', 'Next duty / resolved'] The first-adjustment same-day doctor call, next-day reconciliation, relief-only reassessment and adverse-response review are event-specific loops. They run alongside the appointment pipeline; software never makes their clinical decision. ['care-first-adjustment', 'care-first-adjustment-call', 'care-doctor-call-list', 'care-relief-path', 'care-adverse-response', 'care-trial-care', 'care-special-consult', 'care-at-risk'] ### Financial & claims ['Facts pending', 'Options prepared', 'Discussion due', 'Agreement documented', 'Payments due', 'Reconciliation', 'Coverage change', 'Human resolution'] Financial readiness runs beside the care journey. A payment does not prove attendance or clinical consent. ['rec-financial-options', 'rec-otc-payments', 'rec-billing-limits', 'rec-auto-intake', 'rec-workers-comp', 'rec-claim-transition', 'rec-financial-audit', 'grow-financial', 'care-billing-review', 'care-billing-complaint', 'care-issue-routing', 'rec-insurance-change'] ### Education & family follow-through ['Milestone assigned', 'Invitation delivered', 'Attendance / receipt recorded', 'Question open', 'Follow-through complete'] Daily education, workshops, family invitations and progress explanations retain their own source-driven obligations. ['rec-education', 'rec-day3', 'rec-private-rof', 'care-family-check', 'grow-internal-education', 'grow-advanced-talk', 'rec-family-invitation', 'care-weekly-rhythm'] ### Marketing & relationships ['Campaign planned', 'Audience reviewed', 'Invitation prepared', 'Contact due', 'Response', 'Appointment', 'Attendance', 'Thank-you / follow-up', 'Measured'] Annual review, reactivation, Family Day, seasonal programs, referrals and professional relationships each retain their own sequences. See the complete Marketing library. ['rec-referral-reward', 'rec-reactivation', 'grow-new-year-reactivation', 'grow-valentine-reactivation', 'grow-charity-campaign', 'grow-family-day', 'grow-three-week-promo', 'grow-pgc-call', 'grow-screening', 'grow-business-outreach', 'grow-physician-outreach', 'grow-partner-network', 'grow-survey-lead', 'grow-internal-referrals', 'grow-lead-raffle', 'grow-testimonial', 'grow-patient-month', 'grow-low-volume'] ### Staff & practice operations ['Recurring duty due', 'Assigned', 'Accepted', 'Evidence submitted', 'Reviewed', 'Exception / handoff'] Opening, lunch, closing, supplies, cash, training and weekly targets must be as visible as patient follow-up. ['rec-frontdesk-shift', 'rec-enrollment-shift', 'rec-cash-drawer', 'rec-training', 'rec-task-handoff', 'rec-weekly-targets', 'rec-supplies', 'care-doctor-day', 'care-marketing-day', 'care-marketing-hierarchy', 'care-marketing-stats', 'grow-enrollment-priority', 'care-doctor-training', 'care-marketing-training', 'care-quality-capture', 'care-film-processing', 'care-processor-maintenance'] ## Task contract ### A precise trigger Create work from a durable fact: appointment missed, Day 1 complete, visit count reached, first adjustment complete, invitation sent, financial review due or staff shift started. Store the event and its version. ### One accountable owner Use the book’s Front Desk, Enrollment, Doctor and Marketing roles. Assign an actual person for the shift, a backup and a supervisor. Role-only assignments without a staffed roster are blocked, visible work. ### Source + script at the point of work Every task links to the exact workflow, source photograph, approved script version and required outcome form. Original text remains visible next to any modern adaptation. ### A real due time Use the book’s relative timing and frequency. Where the book is silent, require an explicit practice policy; proposed staff acceptance targets are configurable and never silently borrowed from the sales system. ### An outcome that means something Accepted, attempted, reached, rebooked, resolved and delivered are different states. A no-answer call records an attempt and schedules the next source step; it does not complete the patient objective. ### Evidence before transition Record appointment ID/version, call outcome, discussion note, document version, attendance, payment reference or reviewed exception as appropriate. A checkbox alone is insufficient for consequential transitions. ### Visible escalation Unaccepted work goes to backup; overdue or repeated failed work goes to the role lead; clinical concerns go to the doctor. No staffed recipient means an operational incident, not a successful notification. ### Stop and replacement rules Before every touch recheck booking, patient response, clinical hold, chosen care path, contact permissions and current task version. Cancel superseded work; retain unresolved obligations and their history. ### Delivery reconciliation Persist the exact proposed message and unique purpose before sending. Known rejection may retry; unknown acceptance is held for receipt reconciliation. An outage must not create a burst of stale reminders. ### Shift-close reconciliation Compare completed visits with missing checkout, future appointments, doctor calls, finances and education tasks. Every unresolved item is carried to a named next owner, with a visible exception if no owner accepts. ## Independent architecture ### Independent ownership A new Chiropractic Operations owner with its own home, runbooks, source register, releases and incident queue. No jurisdiction, cron jobs or action permissions under the Sales Operations Hermes agent. ### Separate application and repository Dedicated chiropractic web application, API and worker codebase; independent CI and deployment. The proposal app is a separate static service. Future clinical software is a separate implementation release, not added to sales-desk. ### Separate persistence Dedicated database, document store, backups, queues and encryption material. No shared sales tables, volumes, event topics, migrations or customer IDs. Test and production environments are separate as well. ### Separate integrations Use independent clinic calendar, telephony/SMS, email sender, payment and practice-management connections. New scoped credentials and webhooks; do not reuse the booking bot key, home-service contacts, calendars, phone number or sales APIs. ### Infrastructure boundary The requested chiro.tiexteriors.com address can share OVH’s generic hosting infrastructure, with a separate app/container and access boundaries. It shares no sales software. A dedicated VM can be chosen for production isolation without changing the domain. ### Patient and episode model Separate person, consent/contact preferences, care episode, clinician-approved plan, completed visit count, appointment version, financial arrangement, campaign membership and staff task. One person may have several duties without contradictory pipeline stages. ### Source and policy registry Immutable page IDs, exact source text, script versions and workflow versions. Approved clinic decisions fill explicit source gaps. Running sequences pin their version; later policy changes need reviewed migration. ### Deterministic workflow engine Persist events and due jobs transactionally; idempotent event IDs, appointment revisions and task locks prevent duplicate actions. Restart-safe due-work selection replaces an agent remembering who to contact. ### Bounded AI assistance Luna may classify replies, retrieve the exact approved script and draft a suggested response with source citations. Typed actions, current state and permission checks constrain execution. Clinical assessment stays with licensed personnel. ### Practice-management boundary Choose the clinic’s EHR/practice-management system before building its adapter. Clinical notes, orders and billing remain in the selected authoritative system; this workflow layer tracks obligations and references, not an unreviewed duplicate medical chart. ### Staff and patient access Staff sign in with role-appropriate access. Notifications use scoped, expiring task links; patient-facing links cannot reveal staff notes. The public proposal remains free of actual patient data; the future staff app is authenticated. ### Operational observability Independent health for incoming-event freshness, due-job delay, reachable owners, delivery uncertainty, source-version drift, unmatched events and missing future appointments. “Worker running” alone is insufficient. ### Recovery and evidence Encrypted backups, tested restoration, append-only action history and an audited replay tool. Provider outages, duplicate webhooks, wrong patient matches and ambiguous sends go to explicit resolution queues. ## Proposed modern additions ### A text beside a prescribed call The source calls for a human phone call. Keep the call task and its exact script. Where permitted, add one neutral logistical SMS after the recorded attempt or as a confirmation. A text does not complete or replace the call. Hi {{firstName}}, this is {{staffName}} at {{practiceName}}. We tried to reach you about your appointment. Please call {{phone}}, or reply with a good time to talk. Proposed wording, not quoted from the book. Use only for an appointment matter, with appropriate contact permission; suppress once resolved or declined. ### Patient-requested callback Recall and follow-up conversations identify the actual reason and next step. Store the patient’s requested time, pause generic reminders and create one owned callback. On no answer, return to the applicable approved source branch, not a brand-new opening sequence. Thanks, {{firstName}}. {{staffName}} will call {{callbackWindow}}. If that changes, please let us know. Proposed confirmation; no invented repeat cadence. ### Appointment confirmation and movement Source reminders and scheduling instructions vary by visit stage and frequency. Use an SMS confirmation companion with the actual visit type, time and reschedule path. Move the appointment version and cancel old reminders atomically. Your appointment at {{practiceName}} is {{dateTime}}. Please call {{phone}} if you need to change it. Proposed logistical copy. No diagnosis, debt, clinical claim or coercive wording in notification previews. ### Exact staff script link The book gives role-specific scripts and checklists. Deliver “why this task exists,” the source timing, full approved script, patient-safe context and required outcome in one staff page. Push/email is a notification; completion occurs in the task record. {{taskTitle}} · due {{dueTime}}. Assigned to {{ownerName}}. Open the script and record the outcome: {{staffTaskLink}} Proposed staff notification; authenticated/scoped link in the future build. ## Rollout ### 01 · Freeze the source Approve the 166-photo inventory, page mappings, duplicates, uncertain passages and exact script registry. Resolve missing-source questions with the mentor or original book. Every supplied page has obligations, workflow links or an explicit reference/duplicate disposition. No claim of unseen-page completeness. ### 02 · Decide practice policy Choose conflicting recall thresholds, review timing, roster/coverage, contact permissions, escalation targets, present-day financial facts and clinical wording. Choose the separate clinic integration stack. Every unresolved numeric or clinical policy has an owner; no guessed setting silently becomes executable. ### 03 · Build the independent foundation Create the dedicated database/API/worker, access roles, source registry, event journal, task ledger, separate integration adapters and observability. Demonstrate isolation from all sales-system credentials, APIs, volumes and workers; restore a test backup. ### 04 · Implement by patient journey Reception and Day 1 → ROF/Day 3 → active care/reviews → recovery/recall → finances/operations → every marketing and relationship program. Each workflow has executable trigger, owner, schedule, branches, stop conditions, exact script and test fixture. Every page obligation is accounted for. ### 05 · Run shadow cases Use synthetic patients and a non-sending mode, then authorized staff shadow review. Exercise the happy path and every drop-off, wrong match, stale timer and outage branch. No unsuppressed duplicates; no task resolved without resolution evidence; all unresolved work appears in a staffed queue. ### 06 · Pilot and activate deliberately One clinic/team and a bounded workflow cohort first. Staff review the day-close exceptions and task usability. Expand only after each cohort passes. Separate later authorization to activate patient-facing workflows. This proposal does not send, book, bill or treat anyone. ## Acceptance scenarios - All 166 supplied photographs resolve to a page record; every source workflow and script link resolves; duplicate pages retain their own provenance. - A first-visit cancellation cancels the old reminders and opens the correct Day 1 recovery action without confusing it with a missed ROF or Day 3. - A missed appointment creates the book-prescribed call at the source-defined time; a companion SMS never discharges that call. - No answer records an attempt and the appropriate next step; only a supported outcome closes the patient obligation. - Every departed patient has the next appointment or an explicit reviewed disposition; missing checkout becomes visible before shift close. - First-adjustment doctor calls, three-visit trial review and milestone re-exams survive a worker restart and staff shift change. - A booked appointment does not increment completed-visit counts. Duplicate completion events increment once; corrections preserve audit history. - A reschedule invalidates old appointment-version tasks and notifications; a late webhook cannot restore them. - An inactive recall and a seasonal campaign cannot independently call/text the same patient for the same purpose without coordination. - Patient-requested delay, refusal, opt-out and clinical hold prevent inappropriate automated touchpoints while preserving necessary human obligations. - If the assigned receptionist is absent or never accepts, a staffed backup receives the task; failed notification routing is an incident. - Unknown send outcome is reconciled before retry. Provider acceptance, delivery and patient response remain separate evidence. - An insurance-limit change opens the appropriate financial review; no script guarantees coverage without verified current facts. - Clinical review gates prevent old disease claims, blanket imaging schedules or coercive language from becoming auto-delivered advice. - Every campaign invitation has the book’s response/five-day-call/attendance/thank-you branch where specified; no irrelevant marketing timer restarts after booking. - Daily cash reconciliation, supplies, opening/closing and training pass-offs have owners, evidence and missed-duty escalation. - An independent deployment cannot read or write sales customer data, call a sales action API, consume sales event queues or share its credentials. - Downtime recovery skips obsolete reminders and re-evaluates current context; it does not dump a backlog of stale messages on patients. ## Canonical workflow families The 150 records are granular procedure specifications, including role views and repeated teaching material. They are not 150 independent patient enrollments. The canonical families below define shared event identity. Future compilation selects one approved sequence per purpose, then emits distinct role tasks. Use patient episode + canonical family + originating event/version + action purpose + responsible role as the deduplication scope; never photo ID. Unlisted standalone procedures retain their own stable workflow ID. ### Inbound and prospect intake Starting specification: rec-inbound-booking Related source views: rec-inbound-booking, care-primary-booking, grow-prospect-discovery, grow-new-patient-booking, rec-marketing-call ### Day 1 role handoffs Starting specification: rec-day1-frontdesk Related source views: rec-day1-frontdesk, rec-day1-consult, care-day-one, grow-day1 ### ROF preparation and discussion Starting specification: rec-rof-preparation Related source views: rec-rof-preparation, rec-rof-invitation, rec-group-rof, rec-private-rof, care-rof-booking, care-orientation-rof, grow-day2 ### Day 3 completion Starting specification: rec-day3 Related source views: rec-day3, grow-day3, rec-quality-fileflow ### Financial discussion Starting specification: rec-financial-options Related source views: rec-financial-options, grow-financial ### First adjustment and follow-up Starting specification: care-first-adjustment Related source views: care-first-adjustment, care-first-adjustment-call, rec-doctor-calls, care-doctor-call-list ### Missed first visit Starting specification: grow-day1-missed Related source views: grow-day1-missed, rec-missed-onboarding, care-marketing-recall ### Missed Report of Findings Starting specification: grow-day2-followthrough Related source views: grow-day2-followthrough, rec-missed-onboarding, care-inactive-recall ### Missed Day 3 Starting specification: grow-day3-missed Related source views: grow-day3-missed, rec-missed-onboarding, care-inactive-recall ### Missed routine care Starting specification: rec-missed-visit Related source views: rec-missed-visit, grow-regular-missed, rec-recall-lists, care-inactive-recall ### Inactive check-in and return Starting specification: rec-reactivation Related source views: rec-reactivation, grow-inactive-checkin, rec-inactive-return, care-returning-inactive, grow-inactive-return ### Twelve-visit re-exam Starting specification: rec-reexam Related source views: rec-reexam, care-re-exam, grow-reexam ### Comparison review and re-report Starting specification: rec-rereport Related source views: rec-rereport, care-comparison-imaging, care-re-report, grow-rereport ### Private concern resolution Starting specification: rec-room4 Related source views: rec-room4, grow-room4, care-special-consult, care-at-risk, care-issue-routing ### Referral and family follow-through Starting specification: rec-referral-reward Related source views: rec-referral-reward, care-referral-thanks, care-referral-capture, grow-internal-referrals, rec-family-invitation, care-family-check ### Every-visit scheduling and continuity Starting specification: rec-calendar Related source views: rec-calendar, rec-arrival, rec-checkout, care-visit-loop, grow-travel-card, care-calendar-change ### Doctor daily and quality close Starting specification: care-doctor-day Related source views: care-doctor-day, care-quality-capture, rec-doctor-delivery, rec-quality-fileflow ### Marketing operating rhythm Starting specification: grow-recurring-marketing-calendar Related source views: grow-recurring-marketing-calendar, care-marketing-events, care-marketing-day, care-marketing-hierarchy, care-marketing-stats, grow-event-setup ### Education and workshops Starting specification: rec-education Related source views: rec-education, care-weekly-rhythm, grow-internal-education, grow-advanced-talk ### Discontinuation and quality routing Starting specification: rec-discontinuation Related source views: rec-discontinuation, care-departure, grow-qc-exit ### Phone coverage Starting specification: rec-phone-coverage Related source views: rec-phone-coverage, grow-phone-coverage ### Gift certificate acquisition Starting specification: grow-pgc-handout Related source views: grow-pgc-handout, grow-pgc-call, care-pgc-partner ### Business and professional relationships Starting specification: grow-business-outreach Related source views: grow-business-outreach, care-community-outreach, grow-partner-network, grow-physician-outreach ## Future data model ### Person Identity, preferred contact method, explicit communication preferences, household links when appropriate. ### Care episode Clinician, clinical plan reference, current journey stage, care preference, start/end reason. ### Appointment Type, start/timezone, staff/room, revision, confirmation, arrival and completion events. ### Obligation Trigger, episode/appointment reference, owner, backup, due/accept/escalation times, script version, outcome and evidence. ### Sequence run Workflow version, current step, stop conditions, latest patient response, attempt history. ### Message intent / receipt Purpose, template version, channel, exact rendered text, idempotency key, provider receipt and uncertainty state. ### Visit milestone Completed-visit counter, next review threshold, education item, clinician authorization. ### Financial arrangement Verified payer facts, agreed options, payment references, outstanding review; no inferred coverage guarantee. ### Source / script / policy Photo citation, exact excerpt, provenance label, review status, effective version and conflict decision. ### Campaign / relationship Audience basis, contact permission, invitation, response, booked/attended status, follow-up and measured outcome. ### Shift / roster / competency Actual owner and backup, availability, pass-offs, recurring duties and sign-off evidence. ### Exception / audit event Failure reason, responsible owner, required recovery, immutable timestamps and resolution proof. ## Operational measures ### Unowned / overdue obligations Count by role, age and patient-stage; zero hidden work is the operating target. ### Task reachability Notification routing, staff acceptance and completion are measured separately. ### Visit continuity Patients leaving without a next appointment or intentional disposition; missed-visit recovery outcomes. ### Onboarding completion Day 1 → ROF → Day 3 completion and specific unresolved dependencies, not just conversion rate. ### Review reliability Due and overdue source milestones using completed visits and clinician-approved policies. ### Script fidelity Source version used, approved adaptation, observed outcome, and missing script requests. ### Campaign completion Invited → reached → booked → attended → follow-up; attribute referral and program without duplicating contact. ### Financial / operational closure Unreconciled payments, payer facts, coverage transitions, cash variances and missed recurring duties. ## Research method - Read every supplied photograph’s transcription, OCR and verification notes; retain page-level obligations even when the page is a form, checklist or repeated teaching page. - Use source photographs as the stable citation. Printed page numbers restart, some adjacent sheets are cropped, and repeated material exists. The photo register is an inventory, not a claim that 166 photos equal 166 unique printed pages. - Keep exact source excerpts separate from interpretation. Book actions carry a Book label; proposed orchestration, text companions, UI states and engineering controls carry a Proposed label. - Preserve conflicts and incomplete passages as decisions. Do not quietly choose a convenient cadence, fill a missing script or imply missing pages have been supplied. - Use the sales system’s accountability and evidence patterns as inspiration; redesign the chiropractic domain independently. Never copy home-service outreach timing into the book and call it source-based. ## Present-day communication review references HHS patient email safeguards: https://www.hhs.gov/hipaa/for-professionals/faq/does-hipaa-permit-health-care-providers-to-use-email-to-discuss-health-issues-with-patients/index.html HHS voicemail reminders: https://www.hhs.gov/hipaa/for-professionals/faq/may-health-care-providers-leave-messages/index.html FTC health claims: https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance These references inform the proposed review gate; historical source text is preserved as reference and does not establish medical necessity or current financial policy. ## Home-service reference audit Read-only inspection of the Sales Operations owner map, sales and calendar source snapshots, deployed health/catalog/pipeline endpoints, and synthetic local lifecycle tests. This is a point-in-time operational study, not proof that every branch has executed in production. { "observedAt": "2026-10-02T16:58:40.737661+00:00", "scope": "Read-only inspection of the Sales Operations owner map, sales and calendar source snapshots, deployed health/catalog/pipeline endpoints, and synthetic local lifecycle tests. This is a point-in-time operational study, not proof that every branch has executed in production.", "owner": "Hermes scheduling profile · Sales Operations", "workers": { "sales": { "running": false, "lastErrorPresent": false, "lastStarted": 1790960325546, "lastFinished": 1790960326756, "intervalMs": null }, "quotes": { "running": false, "lastErrorPresent": false, "lastStarted": 1790960325546, "lastFinished": 1790960325551, "intervalMs": null }, "callImport": { "running": false, "lastErrorPresent": false, "lastStarted": 1790960325546, "lastFinished": 1790960325551, "intervalMs": null }, "callAnalysis": { "running": false, "lastErrorPresent": false, "lastStarted": 1790960325546, "lastFinished": 1790960325551, "intervalMs": null }, "payments": { "running": false, "lastErrorPresent": false, "lastStarted": 1790960325546, "lastFinished": 1790960325551, "intervalMs": null }, "email": { "running": false, "lastErrorPresent": false, "lastStarted": 1790960325546, "lastFinished": 1790960325551, "intervalMs": null }, "emailSenders": { "running": false, "lastErrorPresent": false, "lastStarted": 1790960325546, "lastFinished": 1790960325551, "intervalMs": null } }, "jobs": [ { "state": "blocked", "count": 10 }, { "state": "cancelled", "count": 93 }, { "state": "done", "count": 25 }, { "state": "pending", "count": 14 } ], "messages": [ { "state": "delivered", "count": 208 } ], "instances": [ { "phase": "booking", "disposition": "migration_review", "count": 2 }, { "phase": "booking", "disposition": "pipeline_review", "count": 8 }, { "phase": "closed", "disposition": "staff_closed", "count": 1 }, { "phase": "remote_quote", "disposition": "active", "count": 2 }, { "phase": "remote_quote", "disposition": "human_owned", "count": 1 } ], "taskKinds": { "staff_response_review": 3, "inquiry_ambiguity": 10, "migration_review": 2, "pipeline_reconciliation": 8, "appointment_reconciliation": 8, "contact_recovery": 2, "acquisition_call": 4, "requested_call": 1 }, "taskCount": 38, "incidentCount": 0, "capabilities": { "call_analysis": { "configured": 1 }, "call_content_retention": { "configured": 1 }, "call_recording_transcription": { "disabled": 1 }, "staff_app_notification": { "ready": 31, "blocked": 8 } }, "templates": { "sms": 70, "email": 11 }, "customAutomationCount": 0, "pipeline": [ "New", "Contacting", "Estimate Scheduled", "Quote Needed", "Quote Sent / Decision Pending", "Approved / Scheduling", "Job Scheduled", "Completed" ], "sourceCommit": "3738d1a546a9d3f2102b8083ea87907b91956325", "deployedCommit": "cedd97e8c55bacb9b1db31dbdad6e7039985a5d6", "sourceFingerprint": "5c1602e6ab17e6b2633d7d701b51c6fe34d923254ce38d568a58a3d4fecefc63", "runtimeFingerprint": "1e13a8f2789c2550f1af223d44b11b8665ddd53b4ee7096806582946d9043a5f", "tests": { "passed": 48, "failed": 0, "scope": "Local extracted checkout, synthetic fixture transport and temporary databases. lifecycle.test.mjs, lifecycle-adversarial.test.mjs and lifecycle-audit.test.mjs. No live messages or mutations." }, "findings": [ { "title": "Forty-eight selected synthetic lifecycle tests pass after exact dependency restoration", "evidence": "Latest lifecycle-tests.log reports tests48/pass48/fail0. The earlier attempt aborted because extracted pipelines/default.json was absent; parent restored exact source definitions and missing modules before rerunning.", "status": "Local synthetic source test result; verified log", "implication": "Supports inspected source behavior for tested scenarios only. It does not prove the fingerprint-different deployed release or real provider integrations work identically." }, { "title": "Requested task module is absent; task behavior is distributed", "evidence": "No lifecycle-tasks.mjs exists in the inspected extract. lifecycle-state.mjs creates tasks; lifecycle.mjs routes and notifies; lifecycle-pages.mjs handles accepted/completed actions; lifecycle-holds.mjs governs human ownership.", "status": "Observed source structure", "implication": "A faithful mapping must cover all four pieces, not only database task creation." }, { "title": "Live activity and authored coverage are different", "evidence": "Snapshot shows 14 lifecycle instances, 208 delivered messages, 10 blocked / 93 cancelled / 25 done / 14 pending jobs. Open-task sample has 38 entries.", "status": "Live aggregate snapshot, not a longitudinal audit", "implication": "This proves an operating durable lifecycle exists but does not prove each source phase or branch has been exercised successfully in production." }, { "title": "Idle worker flag does not mean disabled", "evidence": "Snapshot worker running flags are false, last-error flags false, with latest tick close to capture time. intervalMs is null.", "status": "Point-in-time observation", "implication": "Describe workers as observed between runs with recent completion, not turned off. Null interval is unavailable timing metadata, not zero frequency." }, { "title": "No message incidents does not mean all staff can receive work", "evidence": "Snapshot incident sample count is zero, but capabilities include eight blocked entries and one disabled capability (call recording/transcription); two configured and 31 ready entries.", "status": "Observed multi-layer health discrepancy", "implication": "Keep task ownership, delivery, capability readiness and message-incident health separate. A notification failure must remain a visible operations problem even when no provider message failed." }, { "title": "Zero custom automations does not mean no automations", "evidence": "customAutomationCount is zero while runtime copy catalog exposes 70 SMS and 11 email definitions and the lifecycle ledger contains delivered messages/jobs.", "status": "Observed product-layer distinction", "implication": "The comprehensive automation engine is code-defined; do not use custom-automation-table count as total automation inventory." }, { "title": "Source checkout cannot attest the current deployed release", "evidence": "Parent audit confirmed a different deployed commit from the checkout plus uncommitted files, with working-source and live release fingerprints differing. Owner lifecycle copy definition hash matches the current observed copy hash.", "status": "Mixed evidence with limited scope", "implication": "Matching copy-definition hash attests template equality only; it does not prove delivery/task execution code equality. Label source-derived behavior as design found in inspected code until exact deployed files/tests are verified." }, { "title": "Owner catalogs require field-by-field freshness checks", "evidence": "Owner lifecycle and pipeline catalogs carry September 29 observation/generation dates. A newer October 2 runtime observation exists.", "status": "Catalog age observed", "implication": "Do not globally dismiss all catalogs as wrong: the copy hash currently matches. Treat stage topology, enablement, capabilities and defaults separately and prefer runtime facts." } ], "principles": [ { "name": "Separate application and ownership boundary", "sourceEvidence": [ "Explicit user instruction" ], "homePattern": "Existing sales lifecycle is reference evidence only.", "chiropracticProposal": "Create an independent chiropractic application, owner/service identity, database, secrets, communication-provider configuration, worker queues, deploy/release and audit records. Import only reviewed source-book requirements and architecture concepts.", "bookBridge": "Book divisions and clinical duties become the new application’s own roles.", "boundary": "No modifications to sales, no cross-application patient/contact writes, no shared task queues or inherited sales defaults, and no live sales credentials copied into the chiropractic stack." }, { "name": "Stage and disposition are separate", "sourceEvidence": [ "lifecycle-state.mjs:5", "lifecycle-state.mjs:8" ], "homePattern": "A durable phase is distinct from active, human-owned, deferred, suppressed and review dispositions.", "chiropracticProposal": "Keep patient stage (Day1, ROF, Day3, active care, re-exam, re-report, care-plan review) separate from current blockers (awaiting patient, awaiting clinician, financial issue, declined, recall).", "bookBridge": "CAL/COM/LA/RE/RR and scheduled/not-scheduled file bins represent simultaneous operational context.", "boundary": "A pipeline move alone must not silently resolve every open concern." }, { "name": "One accountable owner plus backup and supervisor", "sourceEvidence": [ "lifecycle-state.mjs:33", "lifecycle.mjs:318", "lifecycle-staff-recipients.mjs" ], "homePattern": "Task has owner, backup, accept-by, due, fallback and escalation; extra watchers do not dilute owner accountability.", "chiropracticProposal": "Assign each front-desk, Enrollment, Billing, Doctor and Quality obligation one named role/person with accepted, due, backup and manager states; observers are separate.", "bookBridge": "Book Division1/2/3/4/5/7 signatures, huddle and doctor call-list routing.", "boundary": "Home defaults of 5/10/20/60 minutes are inspiration, not book-prescribed clinic cadence. Keep book twenty-minute missed-call rule exact; approve remaining SLAs explicitly." }, { "name": "Task links contain the script and the action", "sourceEvidence": [ "lifecycle-pages.mjs:57", "lifecycle-pages.mjs:128" ], "homePattern": "Staff task view provides context, reason, deadline, script, actual relevant document/appointment and typed completion actions.", "chiropracticProposal": "Every staff notification links to a secure task with exact approved script, source page, checklist, patient/context and completion evidence.", "bookBridge": "Reception script, Room4 prep, missed appointment call, financial checklist and routing form.", "boundary": "Use authenticated clinic access; do not place patient details in public proposal or notification preview." }, { "name": "Accepted is not completed; completion needs evidence", "sourceEvidence": [ "lifecycle-state.mjs:40", "lifecycle-pages.mjs:194", "lifecycle-pages.mjs:197" ], "homePattern": "Task accept only acknowledges ownership. Specialized tasks cannot be marked complete with a generic click; exact booking, document, visit or communication evidence is required.", "chiropracticProposal": "Call task records attempt/result and next state; ROF requires reviewed outcomes; financial requires approved signed agreement; Quality requires all actual prerequisite checks.", "bookBridge": "Signed routing form and file separation only after Quality.", "boundary": "An unanswered call is a completed attempt, not a completed patient-recovery obligation." }, { "name": "Versioned appointments invalidate stale actions", "sourceEvidence": [ "lifecycle-state.mjs:137", "lifecycle-adversarial.test.mjs:15", "lifecycle-adversarial.test.mjs:16" ], "homePattern": "Reschedules cancel prior appointment-specific tasks and stale ETA/arrival/outcome events are rejected by schedule version.", "chiropracticProposal": "Bind reminders, missed-visit triggers and room/doctor preparation to the current visit version. A reschedule cancels obsolete reminders and re-arms only relevant tasks.", "bookBridge": "Manual/computer/calendar reconciliation and RS date/time.", "boundary": "Same appointment identifier is not enough if time or purpose changed; no assumption that old patient confirmation applies." }, { "name": "A reply pauses competing nurture until answered", "sourceEvidence": [ "lifecycle-state.mjs:59", "lifecycle-delivery.mjs:23", "lifecycle.mjs:339" ], "homePattern": "Inbound message invalidates queued customer jobs, newest inbound wins, and unanswered replies create recovery obligations.", "chiropracticProposal": "When patient asks a question or flags symptoms/finance, pause irrelevant retention copy, assign the right human and preserve permitted logistical tasks.", "bookBridge": "Book says investigate what is wrong and route Room4/doctor rather than mechanically repeat the calendar.", "boundary": "Clinical concerns go to qualified staff; the booking/communication agent must not diagnose or override patient answers." }, { "name": "Human handoff has an explicit release and next step", "sourceEvidence": [ "lifecycle-holds.mjs", "lifecycle-state.mjs:203", "lifecycle-state.mjs:208" ], "homePattern": "Human-owned conversation remains held until all conversation obligations are resolved with provenance; release resumes current obligation rather than the opener.", "chiropracticProposal": "Room4, doctor consult, money problem and clinical concern all pause relevant sequences. Releasing requires resolved issues plus a next visit/task or explicit decline.", "bookBridge": "Book problem-solving meeting must fix all concerns or book another information-gathering meeting.", "boundary": "Do not resume generic recall just because one staff note was completed while another concern remains open." }, { "name": "Identity ambiguity blocks outreach", "sourceEvidence": [ "lifecycle-state.mjs:52", "lifecycle-delivery.mjs:20" ], "homePattern": "Multiple active offers sharing one contact create inquiry-ambiguity tasks; no arbitrary process is selected.", "chiropracticProposal": "Resolve family/shared-phone identity and care-episode context before personalized scripts, financial details or clinical follow-up.", "bookBridge": "Family appointment questions, guardian forms and distinct patient calendars.", "boundary": "Do not copy home contact-level assumptions to patients without separate guardian/contact/consent modeling." }, { "name": "Observed delivery is distinct from attempted delivery", "sourceEvidence": [ "lifecycle-delivery.mjs:44", "lifecycle-delivery.mjs:74", "lifecycle-delivery.mjs:82" ], "homePattern": "Sent, delivered, failed and uncertain states are durable; unknown provider acceptance is reconciled before retry.", "chiropracticProposal": "A failed reminder must create reachability work, not count as patient silence. Avoid duplicate SMS when acceptance is unknown; staff calls remain independently tracked.", "bookBridge": "The book expects actual contact and known patient status.", "boundary": "Provider acceptance is not patient reading or understanding, and SMS cannot replace prescribed calls." }, { "name": "No backlog blast after an outage", "sourceEvidence": [ "lifecycle.mjs:327", "lifecycle-audit.test.mjs:14", "lifecycle-audit.test.mjs:24" ], "homePattern": "Expired customer messages are suppressed; delayed nudges coalesce; staff receive the most useful current escalation rather than every missed reminder.", "chiropracticProposal": "On restart recompute current patient situation, expire pre-visit prompts for past appointments, create unresolved-outcome work and send at most appropriate current touchpoints.", "bookBridge": "Daily carry-forward and huddle should reflect current reality.", "boundary": "Never replay every day-one/day-two reminder after a system interruption." }, { "name": "Provider failure is not patient abandonment", "sourceEvidence": [ "lifecycle-audit.test.mjs:16", "lifecycle-delivery.mjs:78" ], "homePattern": "Undelivered outreach with unresolved repair must not close an inquiry as unresponsive.", "chiropracticProposal": "Recall transition depends on actual attempts and known reachability. Failed channels generate staff contact review; they do not prove patient refusal.", "bookBridge": "Know where every patient is; investigate before assuming they fired the practice.", "boundary": "Do not infer a negative patient choice from technical failure." }, { "name": "Document presented, signed and delivered are distinct", "sourceEvidence": [ "lifecycle-audit.test.mjs:28", "lifecycle-audit.test.mjs:30" ], "homePattern": "In-person presentation and signature leave a separate exact-revision digital-copy obligation until delivery proof.", "chiropracticProposal": "Track ROF explained, plan accepted, consent signed, patient calendar/financial copy delivered as independent evidence fields.", "bookBridge": "Book explicitly gives patient white calendar copy and receipts and uses multiple form signatures.", "boundary": "A new document revision invalidates old pending copies; receipt of one file does not prove acceptance of another." }, { "name": "Safe deferral and explicit refusal", "sourceEvidence": [ "lifecycle-state.mjs:212", "lifecycle-audit.test.mjs:33", "lifecycle-audit.test.mjs:34" ], "homePattern": "Requested callback/date carries evidence; ambiguity is not interpreted as refusal or confirmation; late webhook cannot reopen closed case.", "chiropracticProposal": "Separate vacation, asks-call-later, cancel-needs-reschedule, explicit decline and no answer; patient-confirmed make-up differs from an offered slot.", "bookBridge": "NS/NC, CA, RS and MUD in source; source message assumes make-up but handwritten correction says reschedule.", "boundary": "A person declining further care does not remain an endless automated recovery lead." }, { "name": "Role roster changes reopen affected obligations", "sourceEvidence": [ "lifecycle-roster.mjs", "lifecycle-pages.mjs:192" ], "homePattern": "Staff-attested crew capacity/contact changes require review of existing assignments; reassignment records actor, prior owner and reason.", "chiropracticProposal": "When receptionist absent, doctor unavailable or Enrollment role vacant, reassign open tasks and appointment coverage with acknowledgement; scope-limited jobs cannot fall back to unqualified personnel.", "bookBridge": "Book covers duty handoff, special consult scheduling and trained Enrollment versus doctor.", "boundary": "Human attestation of availability is not a guarantee; current staff coverage must remain visible." }, { "name": "Contact limits and permissions are shared across sequences", "sourceEvidence": [ "lifecycle-delivery.mjs:16", "lifecycle-delivery.mjs:27" ], "homePattern": "Suppression, DND, quiet hours, per-contact budgets and spacing apply across competing proactive sequences; email has separate consent/reply validation.", "chiropracticProposal": "Coordinate call/text/email attempts and suppress duplicative reminders. Keep permission and patient preferences at channel/contact level while protecting each patient’s identity.", "bookBridge": "Book says initial voicemail once, no repeated messages and explicit referred-person permission.", "boundary": "Home 4 SMS/day, one email/day, 90-minute spacing and quiet hours are examples of architecture, not clinic or book rules." }, { "name": "Operational health must include staff reachability", "sourceEvidence": [ "lifecycle.mjs:325", "lifecycle.mjs:446", "live-observation.json" ], "homePattern": "A task can exist while its notification capability is blocked; zero provider incidents does not imply healthy dispatch.", "chiropracticProposal": "Manager dashboard shows unowned, unaccepted, overdue, blocked delivery, unavailable role, stale worker and unresolved-source-policy conditions separately.", "bookBridge": "Book end-shift review and Division7 help-needed field provide supervision.", "boundary": "No system can guarantee a person acts; it can make omissions visible, preserve ownership and escalate failures reliably." }, { "name": "Runtime provenance should appear beside audit claims", "sourceEvidence": [ "lifecycle-audit.test.mjs:47", "live-observation.json", "owner/automations/lifecycle-catalog.json" ], "homePattern": "Runtime catalogs are fingerprinted from actual templates; deployed release fingerprint and current checkout can differ.", "chiropracticProposal": "Proposal implementation should version source excerpts, approved clinic policies, scripts and deployed automation, exposing what is proposed, approved and active.", "bookBridge": "Handwritten amendments and duplicate manuals show why source versioning matters.", "boundary": "Never present a source-code reading as proof the matching branch is active or tested in production." } ], "inventory": [ [ "Acquisition / opening", "New inquiry, source attribution, opening sequence, unresponsive lead and acquisition-call obligations.", "Independent clinic inquiry model; book telephone intake drives the actual process." ], [ "Reply and question recovery", "Newest-message processing, question ghost sequence, ambiguity review, opt-out and explicit decline.", "Patient replies invalidate stale reminders; uncertainty opens an owned human task." ], [ "Booking / calendar", "Typed appointments, local ownership, atomic calendar mutation, durable event relay and separate consumers.", "Separate clinic calendar and visit types; do not inherit unlimited home-service overbooking." ], [ "Attendance", "Confirmation, reminders, departure/arrival evidence, visit outcome and no-show recovery.", "Track confirmation, arrival, completion and absence separately. Clinic recovery timings come from the book." ], [ "Estimator / staff accountability", "Scoped task links, acceptance, due, fallback, escalation, call script and outcome.", "Role-based staff workspaces with exact book scripts, backup coverage and completion evidence." ], [ "Quote preparation / presentation", "Quote generation, human review, document version, actual delivery and outstanding digital-copy duty.", "Preparation and delivery gates inspire ROF readiness; no quote software, sales pricing or clinical decision logic is reused." ], [ "Decision / objection / deferral", "Decision-pending follow-up, customer-specified future callback, decline and human-owned holds.", "Source-based trial review, private concern resolution and explicit patient choice." ], [ "Signature / payment", "Verified signed revision and provider payment evidence; independent obligations survive stage movement.", "Separate financial record and consent evidence; treatment authorization is not inferred from payment." ], [ "Work scheduling / crew", "Requested time, readiness, actual crew acceptance and dispatch; signed is not confirmed work.", "A booked slot is not completed care; staff/room readiness remains distinct. No crew or work-order integration." ], [ "Delivery / outage recovery", "Send ledger, provider receipts, uncertain-send reconciliation, retry suppression and receipt events.", "Same design principle in an independently written clinic transport module with separate credentials." ], [ "Call intelligence", "Imported call evidence, configured analysis and retention; recording transcription observed disabled.", "Only approved clinic call evidence can assist staff; transcription is not assumed available." ], [ "Email / staff notifications", "Email jobs, sender readiness, staff fallback and native notification transport.", "New clinic sender and staff channel configuration; test reachability before relying on escalation." ], [ "Recurring operations", "Worker loops, daily backlog, evening schedule, estimator reminders and legacy accountability.", "Clinic opening/closing, next-day schedule, doctor calls, finances and recurring book checklists." ], [ "Legacy / managed ownership", "Managed lifecycle suppresses duplicate legacy outreach; custom definitions and historical catalogs coexist.", "One owner per clinic obligation from day one; no migration or shared ownership with sales." ], [ "Factory / launch controls", "Frozen inputs, route selection, registry, deployment and source-bound launch receipts.", "Separate clinic release and policy gates; the home-service funnel factory is not the clinic runtime." ] ] } ## Complete workflow specifications ### rec-phone-coverage · Live telephone coverage and message handoff Sources: IMG_0239, IMG_0242, IMG_0245, IMG_0260 Trigger: Each business day and every incoming call Owner: Front Desk Manager Purpose: Live telephone coverage and message handoff **preconditions** [] **steps** [ { "action": "Arrange live team-member coverage and correct answering-machine message.", "owner": "Front Desk Manager", "timing": "Monday–Friday 8am–5pm", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0242", "IMG_0245", "IMG_0260" ] }, { "action": "Retrieve messages, record caller and subject, then route to the appropriate person.", "owner": "Reception", "timing": "Opening and during coverage", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0242", "IMG_0245", "IMG_0260" ] }, { "action": "Record delegated off-clock messages and new patients who show for payroll.", "owner": "Reception", "timing": "On each qualifying event", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0242", "IMG_0245", "IMG_0260" ] }, { "action": "Transfer phones at lunch and verify coverage remains assigned.", "owner": "Reception", "timing": "Before lunch", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0242", "IMG_0245", "IMG_0260" ] } ] **branches** [] **completion** "Coverage roster, retrieved-message queue and handoff acknowledgments complete; payroll events recorded." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [ "rec-phone-greeting" ] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "The historical incentive is $1/message and $10/new patient who shows; do not import as current compensation without owner review.", "Voicemail retrieval frequency outside the checklist is not specified." ] **clinicalBoundary** "Clinical decisions remain with the treating clinician; scheduling and task orchestration do not establish medical necessity." ### rec-inbound-booking · Classify and schedule an inbound caller Sources: IMG_0235, IMG_0245, IMG_0246 Trigger: Caller requests an appointment or asks an office question Owner: Reception Purpose: Classify and schedule an inbound caller **preconditions** [] **steps** [ { "action": "Ask when they last saw the doctor to distinguish new from existing patients.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0235", "IMG_0245", "IMG_0246" ] }, { "action": "For a new patient, capture name and phone, source of referral, and whether the appointment is for the person or family.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0235", "IMG_0245", "IMG_0246" ] }, { "action": "Use morning/afternoon choice, then two dates and two times, and give directions.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0235", "IMG_0245", "IMG_0246" ] }, { "action": "Answer the question then move to scheduling.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0235", "IMG_0245", "IMG_0246" ] } ] **branches** [ { "condition": "Existing patient", "action": "Offer appointment using morning or afternoon choice.", "owner": "Reception", "timing": "During call", "nextState": "Scheduled", "basis": "book", "sourcePhotos": [ "IMG_0235", "IMG_0245", "IMG_0246" ] }, { "condition": "Insurance, hours, children or fees question", "action": "Use linked source as reference; current truthful office policies govern the actual answer.", "owner": "Reception", "timing": "During call", "nextState": "Answered / appointment offered", "basis": "inferred", "sourcePhotos": [ "IMG_0235", "IMG_0245", "IMG_0246" ] } ] **completion** "Appointment entered with correct patient type, contact details, referral source and directions provided." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [ "rec-phone-greeting", "rec-inbound-questions" ] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [] **clinicalBoundary** "Do not automatically assert all insurance is accepted, hide required prices, promise fee matching or determine eligibility for child care. IMG_0246 has an annotated “Initial Consult” change." ### rec-calendar · Commit and synchronize the treatment calendar Sources: IMG_0240, IMG_0243, IMG_0244, IMG_0250, IMG_0251, IMG_0258, IMG_0259, IMG_0284 Trigger: New or changed clinician recommendation, LA/CAL/COM flag, or calendar mismatch Owner: Reception Purpose: Commit and synchronize the treatment calendar **preconditions** [] **steps** [ { "action": "Know the doctor’s current recommendation; record the calendar in the travel-card CAL area and in the computer.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0243", "IMG_0244", "IMG_0250", "IMG_0251", "IMG_0258", "IMG_0259", "IMG_0284" ] }, { "action": "Give the patient a copy and explain how to contact reception about changes.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0243", "IMG_0244", "IMG_0250", "IMG_0251", "IMG_0258", "IMG_0259", "IMG_0284" ] }, { "action": "Put calendar changes into Pending during busy adjusting hours and enter or reconcile by end of day.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0243", "IMG_0244", "IMG_0250", "IMG_0251", "IMG_0258", "IMG_0259", "IMG_0284" ] }, { "action": "Check whether the calendar changed on every checkout; last scheduled visit gets LA and a request for a new recommendation.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0243", "IMG_0244", "IMG_0250", "IMG_0251", "IMG_0258", "IMG_0259", "IMG_0284" ] } ] **branches** [ { "condition": "Recommendation unclear", "action": "Send CAL to the doctor; after clarification agree the specific days with the patient.", "owner": "Reception / Doctor", "timing": "At visit", "nextState": "Calendar clarified", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0243", "IMG_0244", "IMG_0250", "IMG_0251", "IMG_0258", "IMG_0259", "IMG_0284" ] }, { "condition": "Recommendation known but not being kept", "action": "Send COM for doctor recommitment and consider Room 4.", "owner": "Reception / Doctor", "timing": "At visit", "nextState": "Commitment review", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0243", "IMG_0244", "IMG_0250", "IMG_0251", "IMG_0258", "IMG_0259", "IMG_0284" ] }, { "condition": "Vacation or unavoidable absence", "action": "Plan make-up visits before or after absence under the clinician’s schedule; source requires missed visits made up within one week.", "owner": "Reception / Doctor", "timing": "When change known", "nextState": "Make-up scheduled", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0243", "IMG_0244", "IMG_0250", "IMG_0251", "IMG_0258", "IMG_0259", "IMG_0284" ] } ] **completion** "Patient copy, travel card and computer agree; next appointment or explicit unresolved-calendar task exists." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [ "rec-calendar-clarify" ] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." }, { "action": "Detect mismatched calendar versions and prevent silent loss of a Pending entry.", "basis": "inferred", "rationale": "Preserves the book’s three-record reconciliation with a digital audit trail." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "Office hours printed are historical M/W/F 8–11am and 3–6pm, Tuesday 3–6pm. Current availability must be configured." ] **clinicalBoundary** "Clinical decisions remain with the treating clinician; scheduling and task orchestration do not establish medical necessity." ### rec-arrival · Every-visit arrival: three things in Sources: IMG_0240, IMG_0244, IMG_0251, IMG_0258, IMG_0263, IMG_0264 Trigger: Patient arrives or walks in Owner: Reception Purpose: Every-visit arrival: three things in **preconditions** [] **steps** [ { "action": "Greet patient, one name per sign-in entry; date travel card and highlight the entire appointment name to show arrival.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0244", "IMG_0251", "IMG_0258", "IMG_0263", "IMG_0264" ] }, { "action": "Check committed calendar, clearly understood financial arrangements and whether a special appointment is due.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0244", "IMG_0251", "IMG_0258", "IMG_0263", "IMG_0264" ] }, { "action": "Recognize Room 4, special consultation, returning inactive, new accident/work injury, re-exam or re-report needs before sending patient back.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0244", "IMG_0251", "IMG_0258", "IMG_0263", "IMG_0264" ] }, { "action": "Observe mood and concerns; communicate flags on the travel card.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0244", "IMG_0251", "IMG_0258", "IMG_0263", "IMG_0264" ] } ] **branches** [ { "condition": "New injury or pain event", "action": "Capture whether work-related or auto-related and what happened using Ouch form; route to clinician and billing.", "owner": "Reception", "timing": "Before routine visit flow", "nextState": "Injury review", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0244", "IMG_0251", "IMG_0258", "IMG_0263", "IMG_0264" ] }, { "condition": "Concern or inactive return", "action": "Seat patient and route to private-room review before a routine adjustment.", "owner": "Reception / Enrollment", "timing": "At arrival", "nextState": "Room 4", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0244", "IMG_0251", "IMG_0258", "IMG_0263", "IMG_0264" ] }, { "condition": "RE or RR completed already by Enrollment", "action": "Remove redundant flag so doctor does not duplicate the work.", "owner": "Reception", "timing": "Before clinician handoff", "nextState": "Ready", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0244", "IMG_0251", "IMG_0258", "IMG_0263", "IMG_0264" ] } ] **completion** "Arrival timestamp, three checks, special-visit routing and relevant flags recorded." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." }, { "action": "A check-in screen exposes CAL, COM, LA, RE, RR, FIN and new-injury flags with current owner.", "basis": "inferred", "rationale": "Replaces post-it visibility while preserving role handoffs." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [] **clinicalBoundary** "Clinical decisions remain with the treating clinician; scheduling and task orchestration do not establish medical necessity." ### rec-checkout · Every-visit departure: two things out Sources: IMG_0240, IMG_0244, IMG_0250, IMG_0251, IMG_0256 Trigger: Patient returns from treatment Owner: Reception Purpose: Every-visit departure: two things out **preconditions** [] **steps** [ { "action": "Check the doctor’s calendar changes.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0244", "IMG_0250", "IMG_0251", "IMG_0256" ] }, { "action": "Remind patient of their next appointment.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0244", "IMG_0250", "IMG_0251", "IMG_0256" ] }, { "action": "Collect fees instructed by Enrollment and give receipt.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0244", "IMG_0250", "IMG_0251", "IMG_0256" ] }, { "action": "Record RS plus new date/time for a rescheduled missed visit in the correct appointment books.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0244", "IMG_0250", "IMG_0251", "IMG_0256" ] } ] **branches** [] **completion** "Next appointment communicated; calendar and money changes queued or entered with an owner." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." }, { "action": "If there is no next appointment, open a last-appointment/decision task instead of marking the episode fully closed.", "basis": "inferred", "rationale": "Makes LA visible before a patient disappears." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "Payment collection belongs to the linked OTC workflow; source does not specify a digital checkout lock." ] **clinicalBoundary** "Clinical decisions remain with the treating clinician; scheduling and task orchestration do not establish medical necessity." ### rec-special-consult · Schedule the right private consultation Sources: IMG_0240, IMG_0242, IMG_0251, IMG_0277 Trigger: Patient needs more time, adherence conversation, RR/RE support, or unresolved concern Owner: Reception Purpose: Schedule the right private consultation **preconditions** [] **steps** [ { "action": "Schedule special consultations in 15-minute blocks outside adjusting hours in the manual appointment book.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0242", "IMG_0251", "IMG_0277" ] }, { "action": "Use trained Enrollment for appropriate RR/RREC meetings when available; otherwise schedule the doctor outside adjusting hours.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0242", "IMG_0251", "IMG_0277" ] }, { "action": "Have the appropriate staff member ready; avoid double booking.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0242", "IMG_0251", "IMG_0277" ] } ] **branches** [ { "condition": "Doctor must come early or stay late", "action": "Clear the extra time with the doctor first.", "owner": "Reception", "timing": "Before booking", "nextState": "Doctor approval needed", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0242", "IMG_0251", "IMG_0277" ] }, { "condition": "Reception senses a concern", "action": "May schedule a normal special-consult slot without doctor permission; route immediate private concerns to Room 4.", "owner": "Reception", "timing": "When detected", "nextState": "Consult scheduled", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0242", "IMG_0251", "IMG_0277" ] } ] **completion** "Named clinician/staff, room and appointment time confirmed; required preparation tasks assigned." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [] **clinicalBoundary** "Clinical decisions remain with the treating clinician; scheduling and task orchestration do not establish medical necessity." ### rec-missed-visit · Rapid response to a missed appointment Sources: IMG_0241, IMG_0247, IMG_0248, IMG_0251, IMG_0284 Trigger: Expected arrival time passes without attendance or a confirmed change Owner: Reception Purpose: Rapid response to a missed appointment **preconditions** [] **steps** [ { "action": "Call the patient and use one initial missed-visit message.", "owner": "Reception", "timing": "Within 20 minutes", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0247", "IMG_0248", "IMG_0251", "IMG_0284" ] }, { "action": "Call again that night if not seen; try to reschedule a make-up the next day.", "owner": "Reception", "timing": "Same evening", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0247", "IMG_0248", "IMG_0251", "IMG_0284" ] }, { "action": "Continue calls without leaving repeated messages. IMG_0241 says call all available numbers at least twice daily.", "owner": "Reception", "timing": "Daily while in active recovery", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0247", "IMG_0248", "IMG_0251", "IMG_0284" ] }, { "action": "Send email and ask the doctor to call if no contact for three days (IMG_0241 variant).", "owner": "Reception / Doctor", "timing": "Day 3", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0247", "IMG_0248", "IMG_0251", "IMG_0284" ] }, { "action": "Mark NS/NC or CA distinctly; a cancellation without rescheduling remains unresolved.", "owner": "Reception", "timing": "At event", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0247", "IMG_0248", "IMG_0251", "IMG_0284" ] } ] **branches** [ { "condition": "Patient answers", "action": "Find the cause, use the four recontact branches, agree a make-up and record RS date/time.", "owner": "Reception", "timing": "On contact", "nextState": "Recovery appointment scheduled", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0247", "IMG_0248", "IMG_0251", "IMG_0284" ] }, { "condition": "No contact persists", "action": "Move into recall under the approved 1-week-versus-2-week policy; preserve the source conflict.", "owner": "Reception / Doctor", "timing": "Policy decision required", "nextState": "Recall policy review", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0247", "IMG_0248", "IMG_0251", "IMG_0284" ] }, { "condition": "Patient returns without having called", "action": "Discuss missed visit, verify current calendar and remind them to call about future changes.", "owner": "Reception", "timing": "Next arrival", "nextState": "Calendar reconfirmed", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0247", "IMG_0248", "IMG_0251", "IMG_0284" ] } ] **completion** "Patient reached and next action agreed, or explicitly assigned recall/clinical/withdrawal disposition." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [ "rec-missed-visit-message", "rec-missed-visit-20min", "rec-recontact-branches" ] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." }, { "action": "Offer a consented SMS companion after the required call, with callback and reschedule link.", "basis": "inferred", "rationale": "Additional modern touchpoint; never substitutes for the prescribed call." }, { "action": "Cancel stale attempts when patient replies, reschedules or declines; deduplicate staff and doctor outreach.", "basis": "inferred", "rationale": "Prevents overlapping sequences and contradictory calls." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "IMG_0248 moves 3x/week patients to recall after one week; IMG_0241 says after two weeks. Longer calendar threshold is unspecified.", "The initial source messages assume a new appointment. Proposed system should record a suggested slot until patient confirmation." ] **clinicalBoundary** "Source suggests emergency contacts, workplace, personal cell and blocked-line calls. Preserve for review but do not automate undisclosed third-party outreach, bypass opt-outs, or conceal identity." ### rec-recall-lists · Weekly recall, monthly recall and doctor escalation Sources: IMG_0241, IMG_0248, IMG_0239, IMG_0260 Trigger: Unreachable patient passes the active missed-visit recovery threshold Owner: Reception / Doctor Purpose: Weekly recall, monthly recall and doctor escalation **preconditions** [] **steps** [ { "action": "Remove future care appointments only after the source threshold decision and put a recurring Saturday AM recall marker with LA on the final entry.", "owner": "Reception / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0248", "IMG_0239", "IMG_0260" ] }, { "action": "Print the Saturday list each Monday and call throughout the week.", "owner": "Reception / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0248", "IMG_0239", "IMG_0260" ] }, { "action": "Copy the travel card to the doctor to join recovery efforts; record outcomes.", "owner": "Reception / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0248", "IMG_0239", "IMG_0260" ] }, { "action": "If still unreachable, explicitly decide whether to move from Saturday AM to the first-Saturday PM monthly list.", "owner": "Reception / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0248", "IMG_0239", "IMG_0260" ] } ] **branches** [ { "condition": "Contact established and appointment scheduled", "action": "Remove from Saturday AM recall.", "owner": "Reception", "timing": "Immediately after scheduling", "nextState": "Reactivated", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0248", "IMG_0239", "IMG_0260" ] }, { "condition": "Doctor and reception cannot make contact", "action": "Ask Executive Director how to proceed.", "owner": "Reception / Doctor", "timing": "After both efforts fail", "nextState": "Executive review", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0248", "IMG_0239", "IMG_0260" ] }, { "condition": "Monthly recall selected", "action": "Include monthly PM group with AM group on first Saturday of month.", "owner": "Reception", "timing": "First Saturday each month", "nextState": "Monthly recall", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0248", "IMG_0239", "IMG_0260" ] } ] **completion** "Each person has an explicit active, weekly recall, monthly recall, declined or management-review disposition." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." }, { "action": "Use real recall tasks rather than fake appointment slots while preserving weekly/monthly cadence labels.", "basis": "inferred", "rationale": "Keeps clinical capacity and actual attendance reporting accurate." }, { "action": "Link doctor and receptionist to a shared attempt history.", "basis": "inferred", "rationale": "Both roles participate without duplicating contact." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "Threshold to move weekly to monthly recall is not specified.", "Two source recall timing variants need owner choice; source doctor 24-hour success story is not a guaranteed deadline." ] **clinicalBoundary** "Outreach channels and frequency require consent-aware office policy. Do not continue if the patient has explicitly opted out." ### rec-reactivation · Find every inactive patient and resolve the actual reason Sources: IMG_0241, IMG_0247, IMG_0249, IMG_0265, IMG_0280 Trigger: Active/inactive review finds missing status or an unkept multiple-appointment plan Owner: Reception / Enrollment Purpose: Find every inactive patient and resolve the actual reason **preconditions** [] **steps** [ { "action": "Review active and inactive patients until the office knows each person’s status; record conversation on travel card and computer.", "owner": "Reception / Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0247", "IMG_0249", "IMG_0265", "IMG_0280" ] }, { "action": "Investigate misunderstanding, feeling better, lack of progress, money, or an unexplained desire to leave.", "owner": "Reception / Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0247", "IMG_0249", "IMG_0265", "IMG_0280" ] }, { "action": "Aim to reschedule at least five inactive patients daily (source reception goal); the source estimates 20–80 non-adjusting-hour calls daily.", "owner": "Reception / Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0247", "IMG_0249", "IMG_0265", "IMG_0280" ] } ] **branches** [ { "condition": "Feels better", "action": "Offer special consultation; distinguish the source’s corrective versus relief choice; if only relief is wanted, source offers monthly care. If declined, ask whether they would feel comfortable returning and seek feedback if not.", "owner": "Reception / Doctor", "timing": "On contact", "nextState": "Preference documented", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0247", "IMG_0249", "IMG_0265", "IMG_0280" ] }, { "condition": "Treatment not working", "action": "Book doctor reevaluation for change in care or referral to another provider.", "owner": "Reception / Doctor", "timing": "On contact", "nextState": "Clinical reassessment", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0247", "IMG_0249", "IMG_0265", "IMG_0280" ] }, { "condition": "Money problem", "action": "Book Enrollment; source says the patient is more important than money.", "owner": "Reception / Enrollment", "timing": "On contact", "nextState": "Financial discussion", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0247", "IMG_0249", "IMG_0265", "IMG_0280" ] }, { "condition": "Wants to stop without clear reason", "action": "Ask for candid improvement feedback and whether the office offended them; record what can and cannot be fixed.", "owner": "Reception", "timing": "On contact", "nextState": "Feedback / decline documented", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0247", "IMG_0249", "IMG_0265", "IMG_0280" ] } ] **completion** "Reason and preference recorded with appointment, referral, exit evaluation or explicit decline." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [ "rec-recontact-branches" ] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [] **clinicalBoundary** "Do not imply inevitable return of pain or require continued care. Monthly care and exit evaluation are patient/clinician choices, not auto-generated treatment plans." ### rec-inactive-return · Route a returning inactive patient before adjustment Sources: IMG_0242, IMG_0244 Trigger: Patient who has not been in for a while walks in Owner: Reception / Enrollment Purpose: Route a returning inactive patient before adjustment **preconditions** [] **steps** [ { "action": "After sign-in seat the patient instead of sending them directly for adjustment.", "owner": "Reception / Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0242", "IMG_0244" ] }, { "action": "Have Enrollment or doctor take them to Room 4; ask where they have been and what they want now.", "owner": "Reception / Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0242", "IMG_0244" ] }, { "action": "Check for new accident/work injury, changed circumstances, need for exam or x-rays, and review prior findings as appropriate.", "owner": "Reception / Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0242", "IMG_0244" ] }, { "action": "Agree the current calendar after the review.", "owner": "Reception / Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0242", "IMG_0244" ] } ] **branches** [] **completion** "Clinical/context review completed and new approved visit plan recorded." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "“A while” is not quantified; do not invent a clinical inactivity cutoff." ] **clinicalBoundary** "Clinical decisions remain with the treating clinician; scheduling and task orchestration do not establish medical necessity." ### rec-reminders · Stage-specific Day 1, ROF and low-frequency reminders Sources: IMG_0242, IMG_0247, IMG_0255, IMG_0269 Trigger: Upcoming Day 1/Day 2 or monthly/forgetful-patient appointment Owner: Reception / Enrollment Purpose: Stage-specific Day 1, ROF and low-frequency reminders **preconditions** [] **steps** [ { "action": "Make tomorrow’s Day 1 and Day 2 reminder calls.", "owner": "Enrollment", "timing": "End of preceding day; ROF at least the preceding shift", "basis": "book", "sourcePhotos": [ "IMG_0242", "IMG_0247", "IMG_0255", "IMG_0269" ] }, { "action": "For Day 1 ask about directions; if forgotten, reschedule and clarify the patient’s concern.", "owner": "Reception / Enrollment", "timing": "Reminder call", "basis": "book", "sourcePhotos": [ "IMG_0242", "IMG_0247", "IMG_0255", "IMG_0269" ] }, { "action": "For Day 2 ask them to write questions and resolve rescheduling; include agreed support person.", "owner": "Reception / Enrollment", "timing": "Reminder call", "basis": "book", "sourcePhotos": [ "IMG_0242", "IMG_0247", "IMG_0255", "IMG_0269" ] }, { "action": "For monthly appointments or patients needing memory support, send a text or call.", "owner": "Reception", "timing": "Day before", "basis": "book", "sourcePhotos": [ "IMG_0242", "IMG_0247", "IMG_0255", "IMG_0269" ] } ] **branches** [] **completion** "Confirmed, rescheduled or contact-attempt result recorded; no-answer remains owned." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [ "rec-day1-reminder", "rec-day2-reminder" ] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." }, { "action": "Add consented logistical SMS confirmation with location and patient-selected support-person reminder after the source call.", "basis": "inferred", "rationale": "The book explicitly permits text for monthly reminders; broader SMS is a modern proposal." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "No-answer reminder retry cadence is unspecified; borrow nothing numeric without labeling it proposed." ] **clinicalBoundary** "Clinical decisions remain with the treating clinician; scheduling and task orchestration do not establish medical necessity." ### rec-missed-onboarding · Recover missed Day 1, Day 2 and Day 3 separately Sources: IMG_0239, IMG_0247, IMG_0260, IMG_0265, IMG_0269, IMG_0270 Trigger: A new patient misses a Day 1, ROF or Day 3 appointment Owner: Enrollment / Reception Purpose: Recover missed Day 1, Day 2 and Day 3 separately **preconditions** [] **steps** [ { "action": "Record the missed stage; missed Day 1 also goes into the NP Missed Log.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0247", "IMG_0260", "IMG_0265", "IMG_0269", "IMG_0270" ] }, { "action": "Enrollment calls and rebooks each missing Day 1/2/3; clear the scheduled and unscheduled file stacks.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0247", "IMG_0260", "IMG_0265", "IMG_0269", "IMG_0270" ] }, { "action": "Report recovered appointment counts on performance sheet.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0247", "IMG_0260", "IMG_0265", "IMG_0269", "IMG_0270" ] } ] **branches** [ { "condition": "Missed Day 1", "action": "Revisit the Primary Script; source treats a weak primary conversation as a likely failure point.", "owner": "Enrollment", "timing": "Recovery call", "nextState": "Day 1 rebooked", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0247", "IMG_0260", "IMG_0265", "IMG_0269", "IMG_0270" ] }, { "condition": "Missed Day 2", "action": "Review how Day 1 went and recover unresolved concerns before rebooking ROF.", "owner": "Enrollment", "timing": "Recovery call", "nextState": "ROF rebooked", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0247", "IMG_0260", "IMG_0265", "IMG_0269", "IMG_0270" ] }, { "condition": "Missed Day 3", "action": "Check whether financial decision-makers were absent or finances felt uncomfortable.", "owner": "Enrollment", "timing": "Recovery call", "nextState": "Day 3 rebooked", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0247", "IMG_0260", "IMG_0265", "IMG_0269", "IMG_0270" ] } ] **completion** "Stage outcome and reason documented; appointment scheduled or explicit declined disposition." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [ "care-primary-script", "grow-primary", "grow-primary-alt" ] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "Source stage explanations are hypotheses, not established reasons for every patient." ] **clinicalBoundary** "Clinical decisions remain with the treating clinician; scheduling and task orchestration do not establish medical necessity." ### rec-day1-frontdesk · Day 1 front-desk intake and routing Sources: IMG_0242, IMG_0253, IMG_0258, IMG_0261 Trigger: New patient arrives for initial visit Owner: Reception Purpose: Day 1 front-desk intake and routing **preconditions** [] **steps** [ { "action": "Confirm reminder call; sign in and provide patient forms including AA/WC variant, copy insurance card and ID, and collect name/DOB/phone and insurance information.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0242", "IMG_0253", "IMG_0258", "IMG_0261" ] }, { "action": "Have patient complete back of travel card down to Office Use Only; make two labels, x-ray card, file/portfolio and give subluxation pamphlet and welcome letter.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0242", "IMG_0253", "IMG_0258", "IMG_0261" ] }, { "action": "Record referral source, promised fees/waivers and insurance in comment/referral area so doctor sees it.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0242", "IMG_0253", "IMG_0258", "IMG_0261" ] }, { "action": "Notify Enrollment, place file on left counter, route verification to Billing/Div 3 and Doctor’s Use Form to Treatment.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0242", "IMG_0253", "IMG_0258", "IMG_0261" ] }, { "action": "Complete reception NP-log fields; collect actual instructed fees and update doctor call list, including first-adjustment status.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0242", "IMG_0253", "IMG_0258", "IMG_0261" ] }, { "action": "Ensure ROF handout and booking appear in manual book; place file into the correct Day 2 bin.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0242", "IMG_0253", "IMG_0258", "IMG_0261" ] } ] **branches** [] **completion** "Reception checklist signed, correct file/insurance handoff and ROF disposition recorded." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [ "rec-day1-fee" ] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." }, { "action": "Block silent stage completion when mandatory intake or next-stage disposition is missing; permit an explicit documented exception.", "basis": "inferred", "rationale": "Digitizes the routing form’s signoffs." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "Two checklist versions differ in tray names; proposed app should preserve equivalent state transitions and resolve operational naming." ] **clinicalBoundary** "Clinical decisions remain with the treating clinician; scheduling and task orchestration do not establish medical necessity." ### rec-day1-consult · Day 1 consultation, exam and next-step handoff Sources: IMG_0265, IMG_0271, IMG_0272 Trigger: Initial paperwork completed and patient ready Owner: Enrollment / Doctor Purpose: Day 1 consultation, exam and next-step handoff **preconditions** [] **steps** [ { "action": "Introduce yourself and take patient to exam room; ask positive and negative prior views of chiropractic.", "owner": "Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0265", "IMG_0271", "IMG_0272" ] }, { "action": "Elicit major health concerns, top two priorities and impact on work/home/hobbies; record patient quotes on travel card in red and rank 1/2.", "owner": "Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0265", "IMG_0271", "IMG_0272" ] }, { "action": "Explain what the doctor will assess using reviewed education; bring doctor in and show recorded concerns.", "owner": "Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0265", "IMG_0271", "IMG_0272" ] }, { "action": "Doctor performs exam and documents findings, appropriate imaging, amount charged, and support-person name for ROF.", "owner": "Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0265", "IMG_0271", "IMG_0272" ] }, { "action": "Perform ordered x-rays through qualified personnel, explain fees, and schedule the next available ROF with handout.", "owner": "Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0265", "IMG_0271", "IMG_0272" ] } ] **branches** [] **completion** "Patient concerns, clinical assessment, charges and next appointment recorded; physician handoff completed." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [ "rec-day1-concerns", "rec-day1-education-archive", "rec-day1-doctor", "rec-rof-invite-spoken" ] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [] **clinicalBoundary** "Source goal of creating “RUIN,” promises of correction, nerve/organ claims and x-ray claims are preserved in archive only. Clinical exam, imaging indication and truthful prognosis require licensed review." ### rec-rof-preparation · Prepare ROF clinical and financial materials Sources: IMG_0253, IMG_0261, IMG_0267, IMG_0269, IMG_0270, IMG_0273, IMG_0282 Trigger: Day 1 completed and ROF upcoming or still unscheduled Owner: Enrollment / Billing / Doctor Purpose: Prepare ROF clinical and financial materials **preconditions** [] **steps** [ { "action": "Verify insurance and hand results to Enrollment.", "owner": "Billing", "timing": "Before financial preparation", "basis": "book", "sourcePhotos": [ "IMG_0253", "IMG_0261", "IMG_0267", "IMG_0269", "IMG_0270", "IMG_0273", "IMG_0282" ] }, { "action": "Complete Doctor’s Use Form, diagnosis and clinician care recommendation; mark and pull x-rays.", "owner": "Doctor", "timing": "Before next shift / ROF", "basis": "book", "sourcePhotos": [ "IMG_0253", "IMG_0261", "IMG_0267", "IMG_0269", "IMG_0270", "IMG_0273", "IMG_0282" ] }, { "action": "Prepare care-plan and financial forms from verified benefits and approved recommendation.", "owner": "Enrollment", "timing": "End of shift for next shift", "basis": "book", "sourcePhotos": [ "IMG_0253", "IMG_0261", "IMG_0267", "IMG_0269", "IMG_0270", "IMG_0273", "IMG_0282" ] }, { "action": "Place file in ROF scheduled or not-scheduled state; on ROF day place films ready in room.", "owner": "Enrollment", "timing": "Before ROF", "basis": "book", "sourcePhotos": [ "IMG_0253", "IMG_0261", "IMG_0267", "IMG_0269", "IMG_0270", "IMG_0273", "IMG_0282" ] }, { "action": "Confirm ROF at least preceding shift and ensure a named staff member is ready.", "owner": "Enrollment", "timing": "Preceding shift", "basis": "book", "sourcePhotos": [ "IMG_0253", "IMG_0261", "IMG_0267", "IMG_0269", "IMG_0270", "IMG_0273", "IMG_0282" ] } ] **branches** [] **completion** "Verified benefits, clinician recommendation, marked films and draft financial ready; unscheduled ROFs remain in follow-up." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "No explicit SLA for payer verification; missing verification must be a visible dependency instead of guessed benefits." ] **clinicalBoundary** "Clinical decisions remain with the treating clinician; scheduling and task orchestration do not establish medical necessity." ### rec-rof-invitation · Book and prepare the Report of Findings visit Sources: IMG_0253, IMG_0254, IMG_0272 Trigger: End of initial visit Owner: Enrollment / Reception Purpose: Book and prepare the Report of Findings visit **preconditions** [] **steps** [ { "action": "Offer next available ROF and ask if there is any reason the patient cannot attend.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0253", "IMG_0254", "IMG_0272" ] }, { "action": "Arrange the agreed spouse/significant other or other decision-support person to attend.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0253", "IMG_0254", "IMG_0272" ] }, { "action": "Explain results, recommendations, finances and home-care review; allow one uninterrupted hour.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0253", "IMG_0254", "IMG_0272" ] }, { "action": "Provide written reminder with date, time, presenter and rescheduling route.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0253", "IMG_0254", "IMG_0272" ] }, { "action": "Discuss child care; source offers a staff member to watch a child if a sitter cannot be found.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0253", "IMG_0254", "IMG_0272" ] } ] **branches** [] **completion** "ROF time, support-person arrangement, duration and reminder delivery recorded." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [ "rec-rof-reminder-sheet", "rec-rof-invite-spoken" ] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [] **clinicalBoundary** "Support-person involvement requires the patient’s choice and appropriate permission; do not impose a spouse as substitute decision-maker. Child-care offer requires an actual approved office capability." ### rec-group-rof · Group ROF arrival, support-person branch and checkout Sources: IMG_0255, IMG_0261 Trigger: Patient arrives for group Report of Findings Owner: Reception / Enrollment / Doctor Purpose: Group ROF arrival, support-person branch and checkout **preconditions** [] **steps** [ { "action": "Clean whiteboard and set out x-rays and spine model; sign patient in.", "owner": "Reception / Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0255", "IMG_0261" ] }, { "action": "Give one “How to choose a chiropractor” pamphlet to each person.", "owner": "Reception / Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0255", "IMG_0261" ] }, { "action": "At the source 6:05pm start take first arrival to front-row wall seat so doctor knows first patient; seat remaining people.", "owner": "Reception / Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0255", "IMG_0261" ] }, { "action": "Enrollment performs ROF and appropriate financial/policy/calendar tasks; doctor adjusts when clinically appropriate.", "owner": "Reception / Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0255", "IMG_0261" ] }, { "action": "Collect fees and 3x5 referral cards with patient, referred name/relationship/phone/age; schedule Day 3 at Enrollment availability.", "owner": "Reception / Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0255", "IMG_0261" ] }, { "action": "If adjusted, give approved doctor contact; complete doctor call list and route file to services entry then Day 3 bin.", "owner": "Reception / Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0255", "IMG_0261" ] } ] **branches** [ { "condition": "Agreed support person absent", "action": "Ask if that person can come now; Enrollment chooses reschedule or ROF attendance with finances deferred until both are present.", "owner": "Enrollment", "timing": "Before financial conversation", "nextState": "Support-person dependency", "basis": "book", "sourcePhotos": [ "IMG_0255", "IMG_0261" ] } ] **completion** "ROF and financial completion recorded separately; Day 3 and service-entry handoff exist." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [ "rec-doctor-cell" ] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "6:05pm is the original group event time, not a universal appointment rule." ] **clinicalBoundary** "Avoid disclosing private clinical information to other group attendees; group structure and consent need current policy. Referral contact requires permission." ### rec-private-rof · Private ROF: explain findings and establish voluntary readiness Sources: IMG_0255, IMG_0273, IMG_0274, IMG_0283 Trigger: Patient attends individual ROF Owner: Enrollment / Doctor Purpose: Private ROF: explain findings and establish voluntary readiness **preconditions** [] **steps** [ { "action": "Give three pamphlets: Degeneration, Types of Care and Nerve Function; include new support person’s questions and prior views.", "owner": "Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0255", "IMG_0273", "IMG_0274", "IMG_0283" ] }, { "action": "Review prior concerns, clinician findings, prescribed calendar, home exercises and workshop expectations.", "owner": "Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0255", "IMG_0273", "IMG_0274", "IMG_0283" ] }, { "action": "Source commitment conversation asks readiness 1–10, explores obstacles even when enthusiasm is high, and then asks readiness to start.", "owner": "Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0255", "IMG_0273", "IMG_0274", "IMG_0283" ] }, { "action": "Explain approved Corrective Care Plan and Financial Summary after readiness discussion.", "owner": "Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0255", "IMG_0273", "IMG_0274", "IMG_0283" ] }, { "action": "Use same exit routing as group ROF: fees, referral cards, Day 3, first-adjustment contact and doctor call list.", "owner": "Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0255", "IMG_0273", "IMG_0274", "IMG_0283" ] } ] **branches** [ { "condition": "Not ready for full program", "action": "Source permits a “by stages” approach and commitment only through first re-exam.", "owner": "Enrollment / Doctor", "timing": "During discussion", "nextState": "Limited-stage decision", "basis": "book", "sourcePhotos": [ "IMG_0255", "IMG_0273", "IMG_0274", "IMG_0283" ] }, { "condition": "Still uncertain", "action": "Explore concerns and agree an appropriate next step rather than mark financial acceptance.", "owner": "Enrollment", "timing": "During discussion", "nextState": "Decision pending", "basis": "inferred", "sourcePhotos": [ "IMG_0255", "IMG_0273", "IMG_0274", "IMG_0283" ] } ] **completion** "Patient’s preference, questions, scope of consent and financial next step recorded." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [ "rec-commitment", "rec-private-rof-financial" ] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [] **clinicalBoundary** "Do not automate repeated pressure to reach 10/10 or medical assertions. Preserve disagreement and patient choice; care acceptance is not an emotional score." ### rec-financial-options · Present and document the financial options Sources: IMG_0267, IMG_0283, IMG_0284, IMG_0288 Trigger: Patient has clinician recommendation and wants to discuss payment Owner: Enrollment Purpose: Present and document the financial options **preconditions** [] **steps** [ { "action": "Gather front-desk insurance, Billing verification and doctor’s travel-card plan.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0267", "IMG_0283", "IMG_0284", "IMG_0288" ] }, { "action": "Prepare a clear full-cost summary separating insurance-covered visits, deductible/copay, other visits, re-exams and x-rays.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0267", "IMG_0283", "IMG_0284", "IMG_0288" ] }, { "action": "Present one-time option first, then monthly; source private ROF allows monthly up to 12 months.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0267", "IMG_0283", "IMG_0284", "IMG_0288" ] }, { "action": "When standard options do not work, ask about finances; source disclosure branch records a P&L and makes a modified plan.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0267", "IMG_0283", "IMG_0284", "IMG_0288" ] }, { "action": "Set agreed automatic payments in Cash Practice and clearly mark travel card, paperwork, computer and NP log.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0267", "IMG_0283", "IMG_0284", "IMG_0288" ] } ] **branches** [ { "condition": "Patient does not want to discuss finances after repeated source prompt", "action": "Offer source three-visit trial and review after third visit.", "owner": "Enrollment", "timing": "During discussion", "nextState": "Three-visit review", "basis": "book", "sourcePhotos": [ "IMG_0267", "IMG_0283", "IMG_0284", "IMG_0288" ] }, { "condition": "No arrangement resolved", "action": "Brief doctor on what is known, then bring doctor into private room.", "owner": "Enrollment / Doctor", "timing": "Same encounter", "nextState": "Doctor financial review", "basis": "book", "sourcePhotos": [ "IMG_0267", "IMG_0283", "IMG_0284", "IMG_0288" ] }, { "condition": "Modified plan agreed", "action": "Record exact terms and clinical scope; do not silently substitute a different plan.", "owner": "Enrollment", "timing": "Before acceptance", "nextState": "Modified plan documented", "basis": "book", "sourcePhotos": [ "IMG_0267", "IMG_0283", "IMG_0284", "IMG_0288" ] } ] **completion** "Approved signed financial summary, payment authorization, exact terms and system records agree." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [ "rec-private-rof-financial" ] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "Compact IMG_0267 lists four steps; detailed IMG_0283 and cross-part IMG_0359–0360 specify modified plan when finances are shared and three-visit trial when uncertain/nondisclosed. Proposed canonical workflow follows the explicit conditional branches and retains the compact outline as a variant.", "Historical $55 visits/$30 re-exams/$90 x-rays and20% discount are examples, not current rates." ] **clinicalBoundary** "No autonomous credit decision, payment, treatment upsell or use of historical interest/collection/refund clauses. Current owner-reviewed financial policy and patient authorization are required." ### rec-three-visit-review · Close the three-visit trial loop Sources: IMG_0267, IMG_0283 Trigger: Patient chooses source three-visit trial instead of full plan Owner: Enrollment Purpose: Close the three-visit trial loop **preconditions** [] **steps** [ { "action": "Record the agreed three-visit option and its limits.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0267", "IMG_0283" ] }, { "action": "Sit down with the patient after the third visit and decide where to go from there.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0267", "IMG_0283" ] } ] **branches** [] **completion** "Third-visit discussion completed and next care/financial decision recorded." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." }, { "action": "Create a visit-count trigger on the third completed trial visit, with a reserved private review and linked source script.", "basis": "inferred", "rationale": "Prevents a temporary trial from becoming an indefinite undefined plan." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "This segment does not state trial price; full-book IMG_0360 (other research part) specifies payment visit-by-visit at the regular fee. Merge that detail into the canonical three-visit workflow.", "After-third-visit clinical/financial decision remains a human discussion; source does not define every outcome." ] **clinicalBoundary** "Clinical decisions remain with the treating clinician; scheduling and task orchestration do not establish medical necessity." ### rec-day3 · Day 3 completion and patient orientation Sources: IMG_0255, IMG_0256, IMG_0261, IMG_0265, IMG_0270, IMG_0275 Trigger: Patient arrives for Day 3 or has remaining Day 2 loose ends Owner: Enrollment / Reception Purpose: Day 3 completion and patient orientation **preconditions** [] **steps** [ { "action": "Reception greets, signs in, seats and notifies Enrollment.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0255", "IMG_0256", "IMG_0261", "IMG_0265", "IMG_0270", "IMG_0275" ] }, { "action": "Finish all paperwork, policies, financial agreements and signatures not already complete.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0255", "IMG_0256", "IMG_0261", "IMG_0265", "IMG_0270", "IMG_0275" ] }, { "action": "Create multiple-appointment calendar; give patient white copy and enter computer with LA on last visit.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0255", "IMG_0256", "IMG_0261", "IMG_0265", "IMG_0270", "IMG_0275" ] }, { "action": "Show office flow and rehabilitation, issue/purchase prescribed equipment and record exercises/equipment/photo on routing form.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0255", "IMG_0256", "IMG_0261", "IMG_0265", "IMG_0270", "IMG_0275" ] }, { "action": "Schedule family members by Day 3; source says children checked within two weeks at doctor’s expense.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0255", "IMG_0256", "IMG_0261", "IMG_0265", "IMG_0270", "IMG_0275" ] }, { "action": "Complete NP checklist/log, computer notes and travel-card financial/calendar markings; Reception collects instructed fees.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0255", "IMG_0256", "IMG_0261", "IMG_0265", "IMG_0270", "IMG_0275" ] }, { "action": "Send completed file to Quality/Div 5.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0255", "IMG_0256", "IMG_0261", "IMG_0265", "IMG_0270", "IMG_0275" ] } ] **branches** [] **completion** "Every checklist item signed or exception documented; calendar, billing, family invitation, rehab and quality handoff have evidence." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [] **clinicalBoundary** "Family checks are an invitation and require individual consent; rehabilitation and equipment are clinician prescribed. The source’s expected x-ray change and compliance language is not a guarantee." ### rec-quality-fileflow · Quality gate before separating file and travel card Sources: IMG_0253, IMG_0255, IMG_0256, IMG_0261, IMG_0266, IMG_0270 Trigger: Day 3 routing checklist reaches completion Owner: Quality Control / Billing / Reception Purpose: Quality gate before separating file and travel card **preconditions** [] **steps** [ { "action": "Billing verifies patient/insurance information, case type, diagnosis/modifiers with injury date and services entered to date.", "owner": "Quality Control / Billing / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0253", "IMG_0255", "IMG_0256", "IMG_0261", "IMG_0266", "IMG_0270" ] }, { "action": "Quality checks travel card patient/insurance/calendar/money/dots/lines, completed NP log, MAP with LA and computer ready to bill.", "owner": "Quality Control / Billing / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0253", "IMG_0255", "IMG_0256", "IMG_0261", "IMG_0266", "IMG_0270" ] }, { "action": "Use stage-specific file route: Day 1 x-ray bin→doctor tray→services entered→to be filed→Day 2 scheduled/not scheduled; Day 2 arrival portfolio→entry→filing→Day 3 scheduled; Day 3 entry→filing→Quality.", "owner": "Quality Control / Billing / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0253", "IMG_0255", "IMG_0256", "IMG_0261", "IMG_0266", "IMG_0270" ] }, { "action": "Only after Quality signs off separate travel card from file; TC goes to bin and file to scan.", "owner": "Quality Control / Billing / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0253", "IMG_0255", "IMG_0256", "IMG_0261", "IMG_0266", "IMG_0270" ] } ] **branches** [] **completion** "Quality signoff and scan/bin destinations recorded; no unsigned prerequisite silently passed." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." }, { "action": "Model files as explicit states and require each receiving role to acknowledge handoff.", "basis": "inferred", "rationale": "Digital equivalent of named trays and signatures." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [] **clinicalBoundary** "Clinical decisions remain with the treating clinician; scheduling and task orchestration do not establish medical necessity." ### rec-doctor-calls · End-of-day doctor call list and closed-loop routing Sources: IMG_0239, IMG_0253, IMG_0255, IMG_0257, IMG_0260, IMG_0261, IMG_0262, IMG_0289, IMG_0290 Trigger: New patient, first adjustment, referral arrival or urgent patient concern Owner: Reception / Doctor Purpose: End-of-day doctor call list and closed-loop routing **preconditions** [] **steps** [ { "action": "Reception fills list throughout day: new patient name/number, referring person/number, ROF date/presenter and adjusted status.", "owner": "Reception / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0253", "IMG_0255", "IMG_0257", "IMG_0260", "IMG_0261", "IMG_0262", "IMG_0289", "IMG_0290" ] }, { "action": "Add first-adjustment patient contact routes and next appointment; add rush name/number, reason and last visit.", "owner": "Reception / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0253", "IMG_0255", "IMG_0257", "IMG_0260", "IMG_0261", "IMG_0262", "IMG_0289", "IMG_0290" ] }, { "action": "Doctor can add concerned/missing patient names and travel-card corrections from personal task card.", "owner": "Reception / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0253", "IMG_0255", "IMG_0257", "IMG_0260", "IMG_0261", "IMG_0262", "IMG_0289", "IMG_0290" ] }, { "action": "Place complete list on counter for doctor at end of day; doctor calls and thanks referrers as indicated.", "owner": "Reception / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0253", "IMG_0255", "IMG_0257", "IMG_0260", "IMG_0261", "IMG_0262", "IMG_0289", "IMG_0290" ] }, { "action": "Treatment informs reception/Enrollment of communication progress; Reception routes result to proper department.", "owner": "Reception / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0253", "IMG_0255", "IMG_0257", "IMG_0260", "IMG_0261", "IMG_0262", "IMG_0289", "IMG_0290" ] } ] **branches** [] **completion** "Each call has outcome and next owner; no list item disappears after doctor contact." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [ "rec-doctor-cell", "rec-referral-thanks" ] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "Cross-part IMG_0295 expands the deadline: first-adjustment calls before leaving that day; doctor list calls that night, notes back to Reception next day, copy unresolved items for later. Merge those source rules rather than leaving the deadline undefined." ] **clinicalBoundary** "Use secure patient context and approved clinician contact route. Referred patient status is confidential." ### rec-referral-reward · Recognize an arrived referral and close the thank-you loop Sources: IMG_0241, IMG_0253, IMG_0257, IMG_0258, IMG_0280 Trigger: New patient Day 1 confirms a referral source Owner: Reception Purpose: Recognize an arrived referral and close the thank-you loop **preconditions** [] **steps** [ { "action": "If referring patient, create alert on their file for next-visit acknowledgment.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0253", "IMG_0257", "IMG_0258", "IMG_0280" ] }, { "action": "Add referrer name and number to doctor call list.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0253", "IMG_0257", "IMG_0258", "IMG_0280" ] }, { "action": "Choose and give appropriate gift with thank-you.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0253", "IMG_0257", "IMG_0258", "IMG_0280" ] }, { "action": "Write arrived referral’s name at bottom right of referring patient’s travel card.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0253", "IMG_0257", "IMG_0258", "IMG_0280" ] } ] **branches** [ { "condition": "Referral source is a business", "action": "Notify office manager to arrange appropriate thanks.", "owner": "Reception / Office Manager", "timing": "When referral arrives", "nextState": "Business thank-you due", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0253", "IMG_0257", "IMG_0258", "IMG_0280" ] } ] **completion** "Arrival-linked attribution, staff thanks and doctor thanks recorded." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [ "rec-referral-thanks" ] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [] **clinicalBoundary** "Gift policy and any disclosure of another person’s care require current review. Do not automate gifts or reveal diagnosis/treatment." ### rec-otc-payments · Record and reconcile over-the-counter payments Sources: IMG_0241, IMG_0245, IMG_0252, IMG_0258, IMG_0259, IMG_0261 Trigger: Approved payment due, payment received or automatic-payment report arrives Owner: Reception Purpose: Record and reconcile over-the-counter payments **preconditions** [] **steps** [ { "action": "Understand the arrangement; ask Enrollment if unclear.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0245", "IMG_0252", "IMG_0258", "IMG_0259", "IMG_0261" ] }, { "action": "Write actual paid amounts in red, owed-unpaid amounts in pencil; mark prepayment through visit and automatic monthly receipt with a line through due month.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0245", "IMG_0252", "IMG_0258", "IMG_0259", "IMG_0261" ] }, { "action": "Give receipt for each payment; original paper copies are white patient, yellow Barb, pink retained.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0245", "IMG_0252", "IMG_0258", "IMG_0259", "IMG_0261" ] }, { "action": "Encourage prepayment/card on file/check prepared in advance according to agreed terms; have receipt ready at checkout.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0245", "IMG_0252", "IMG_0258", "IMG_0259", "IMG_0261" ] }, { "action": "Queue computer entry in Pending during busy times and reconcile report, payment log, payments and receipts by day end.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0241", "IMG_0245", "IMG_0252", "IMG_0258", "IMG_0259", "IMG_0261" ] } ] **branches** [] **completion** "Payment, receipt and agreement reconcile across record and report." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "The source “Taking a payment” list has six blank steps on IMG_0252; there is no hidden complete transaction SOP.", "Modern payment handling should store processor tokens, never card details in the proposal or task notes." ] **clinicalBoundary** "No payment or extra prepayment is inferred from source examples; the patient must authorize actual amounts and terms." ### rec-cash-drawer · Secure and reconcile the change drawer Sources: IMG_0239, IMG_0252, IMG_0260 Trigger: Opening and closing of clinic day Owner: Reception Purpose: Secure and reconcile the change drawer **preconditions** [] **steps** [ { "action": "Retrieve locked cash drawer with key each morning; source starting float is $203.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0252", "IMG_0260" ] }, { "action": "Use drawer to break larger bills; source example exchanges $50 for smaller bills before taking exact $40 payment.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0252", "IMG_0260" ] }, { "action": "Source alternatively suggests accepting $50 for $25 owed and crediting next visit; mark prepayment only with agreed arrangement.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0252", "IMG_0260" ] }, { "action": "Count nightly, record petty-cash amount and lock away.", "owner": "Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0252", "IMG_0260" ] } ] **branches** [] **completion** "Opening/closing count and any discrepancy documented." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [] **clinicalBoundary** "The $203 float and overpayment examples are historical; do not force unwanted prepayment or deduct unapproved amounts." ### rec-billing-limits · Travel-card insurance verification and coverage boundaries Sources: IMG_0258, IMG_0259, IMG_0261, IMG_0267, IMG_0288 Trigger: Benefits verified, visits consumed or new authorization received Owner: Billing Purpose: Travel-card insurance verification and coverage boundaries **preconditions** [] **steps** [ { "action": "Enter primary and secondary benefits and whether plan year or calendar year; document authorization/ACN requests in insurance notes.", "owner": "Billing", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0258", "IMG_0259", "IMG_0261", "IMG_0267", "IMG_0288" ] }, { "action": "Mark full blue line at last covered visit, or half line when more visits may be requested.", "owner": "Billing", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0258", "IMG_0259", "IMG_0261", "IMG_0267", "IMG_0288" ] }, { "action": "After authorization approval mark new limit line; complete computer patient/insurance, case type, diagnosis/modifiers and injury date.", "owner": "Billing", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0258", "IMG_0259", "IMG_0261", "IMG_0267", "IMG_0288" ] }, { "action": "Give verification to Enrollment before financial preparation.", "owner": "Billing", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0258", "IMG_0259", "IMG_0261", "IMG_0267", "IMG_0288" ] } ] **branches** [] **completion** "Coverage constraints and outstanding requests visible; financial summary uses verified benefits." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." }, { "action": "Convert line markings into remaining-visit and authorization tasks before the next boundary.", "basis": "inferred", "rationale": "Same billing dependency, clearer to staff than a paper line." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "Source does not prescribe advance-warning lead time or payer response SLA." ] **clinicalBoundary** "Benefits verification is not a payment guarantee; clinical need and insurance coverage must remain separate." ### rec-financial-audit · Audit what should have been paid against actual payments Sources: IMG_0265, IMG_0267, IMG_0269, IMG_0274, IMG_0277, IMG_0282 Trigger: Routine travel-card audit, re-sign opportunity or private money concern Owner: Enrollment Purpose: Audit what should have been paid against actual payments **preconditions** [] **steps** [ { "action": "Gather travel card, computer, file, insurance, care plan and prior arrangements.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0265", "IMG_0267", "IMG_0269", "IMG_0274", "IMG_0277", "IMG_0282" ] }, { "action": "Calculate insurance visits, deductible visits, cash visits, exams/x-rays and expected patient total using the applicable verified arrangement.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0265", "IMG_0267", "IMG_0269", "IMG_0274", "IMG_0277", "IMG_0282" ] }, { "action": "Compare original arrangement, actual paid and amount now owed.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0265", "IMG_0267", "IMG_0269", "IMG_0274", "IMG_0277", "IMG_0282" ] }, { "action": "Review active/payment status of travel-card bin and record completed alphabet sections.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0265", "IMG_0267", "IMG_0269", "IMG_0274", "IMG_0277", "IMG_0282" ] }, { "action": "Meet affected patients privately; resolve errors or agree next action.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0265", "IMG_0267", "IMG_0269", "IMG_0274", "IMG_0277", "IMG_0282" ] } ] **branches** [] **completion** "Audit calculation, discrepancy cause, patient discussion and resolution recorded." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "Historical $55 audit rate must not become current fee by assumption.", "Re-sign review is mentioned but detailed new-plan clinical rules are elsewhere." ] **clinicalBoundary** "Clinical decisions remain with the treating clinician; scheduling and task orchestration do not establish medical necessity." ### rec-reexam · Visit-count re-exam and progress review Sources: IMG_0251, IMG_0270, IMG_0276 Trigger: Patient approaches 12th completed visit or clinician deems reassessment necessary Owner: Reception / Enrollment / Doctor Purpose: Visit-count re-exam and progress review **preconditions** [] **steps** [ { "action": "Place 12th visit re-exam in manual appointment book.", "owner": "Reception", "timing": "On 11th visit", "basis": "book", "sourcePhotos": [ "IMG_0251", "IMG_0270", "IMG_0276" ] }, { "action": "Give Initial Progress Evaluation Form.", "owner": "Reception", "timing": "On 12th visit", "basis": "book", "sourcePhotos": [ "IMG_0251", "IMG_0270", "IMG_0276" ] }, { "action": "Pull films, know current calendar/finances and prepare to review improvement, office feedback, referrals and financial clarity.", "owner": "Enrollment / Doctor", "timing": "Before re-exam", "basis": "book", "sourcePhotos": [ "IMG_0251", "IMG_0270", "IMG_0276" ] }, { "action": "Take patient into room before/after adjustment; review form and repeat positive exam findings as appropriate.", "owner": "Qualified clinician / Enrollment within scope", "timing": "At re-exam", "basis": "book", "sourcePhotos": [ "IMG_0251", "IMG_0270", "IMG_0276" ] }, { "action": "Review findings and calendar, address concerns, seek specific referrals when patient pleased, and record notes to correct staff.", "owner": "Enrollment / Doctor", "timing": "At re-exam", "basis": "book", "sourcePhotos": [ "IMG_0251", "IMG_0270", "IMG_0276" ] } ] **branches** [ { "condition": "Second or third re-exam with new films", "action": "Qualified staff obtain clinician-ordered films; place in original folder for doctor marking and schedule next-visit re-report.", "owner": "Doctor / Enrollment", "timing": "As clinically indicated", "nextState": "Re-report due", "basis": "book", "sourcePhotos": [ "IMG_0251", "IMG_0270", "IMG_0276" ] }, { "condition": "Heel lift previously prescribed", "action": "Source says shoes and lift stay on for films; lend a lift if forgotten, subject to clinician protocol.", "owner": "Qualified imaging staff", "timing": "Imaging encounter", "nextState": "Imaging protocol reviewed", "basis": "book", "sourcePhotos": [ "IMG_0251", "IMG_0270", "IMG_0276" ] } ] **completion** "Progress form reviewed, appropriate assessment documented, concerns owned and next re-report/calendar task set." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [ "rec-reexam-four-questions", "rec-reexam-referral" ] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "Whether second or third re-exam receives imaging is not fixed. Clinical indication must govern, not automatic visit count." ] **clinicalBoundary** "No autonomous exam, imaging order, x-ray interpretation or pressure based on organ-damage claims. Preserve patient-reported improvement and limitations." ### rec-rereport · Re-report after repeat imaging Sources: IMG_0242, IMG_0250, IMG_0276 Trigger: New ordered films obtained after a re-exam Owner: Doctor / trained Enrollment Purpose: Re-report after repeat imaging **preconditions** [] **steps** [ { "action": "Doctor marks new films and compares with first set.", "owner": "Doctor / trained Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0242", "IMG_0250", "IMG_0276" ] }, { "action": "Determine whether doctor must present; if so book outside adjusting hours. If trained Enrollment can handle approved discussion, schedule accordingly.", "owner": "Doctor / trained Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0242", "IMG_0250", "IMG_0276" ] }, { "action": "Review films/progress privately, reconfirm visit plan, address barriers and look for appropriate referrals.", "owner": "Doctor / trained Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0242", "IMG_0250", "IMG_0276" ] }, { "action": "Remove RR flag after completion to prevent duplicate presentation.", "owner": "Doctor / trained Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0242", "IMG_0250", "IMG_0276" ] } ] **branches** [] **completion** "Clinician-reviewed findings communicated, next plan recorded and RR flag closed." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [] **clinicalBoundary** "Qualified clinician interprets imaging and determines recommendations; staff deliver only approved education within scope." ### rec-room4 · Room 4: private problem-solving and follow-through Sources: IMG_0240, IMG_0244, IMG_0274, IMG_0277 Trigger: Missed visits, financial issue, calendar concern or other barrier to continuing care Owner: Enrollment Purpose: Room 4: private problem-solving and follow-through **preconditions** [] **steps** [ { "action": "Reception puts patient in private room, pulls available films and alerts Enrollment.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0244", "IMG_0274", "IMG_0277" ] }, { "action": "When time permits, audit finances, compare actual attendance to recommendation, review notes/what staff heard and prepare possible issues.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0244", "IMG_0274", "IMG_0277" ] }, { "action": "If unprepared, use travel card money/calendar/history for quick context and ask the patient directly.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0244", "IMG_0274", "IMG_0277" ] }, { "action": "Discuss actual concern and all other barriers; source uses the four questions when recommitment is needed.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0244", "IMG_0274", "IMG_0277" ] }, { "action": "Resolve what can be resolved; otherwise promise to gather information and book a follow-up meeting.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0240", "IMG_0244", "IMG_0274", "IMG_0277" ] } ] **branches** [] **completion** "Each concern has resolution, owner or scheduled follow-up; privacy preserved." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [ "rec-reexam-four-questions" ] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [] **clinicalBoundary** "Do not label a patient’s concern an excuse or use imaging to pressure consent. Treatment changes and medical explanations require clinician judgment." ### rec-auto-intake · Auto-accident intake and clinical/billing handoff Sources: IMG_0244, IMG_0263, IMG_0278 Trigger: Patient reports automobile accident Owner: Enrollment / Reception Purpose: Auto-accident intake and clinical/billing handoff **preconditions** [] **steps** [ { "action": "Capture fault report, driver/passenger status, all occupants, weather/road/circumstances and patient description.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0244", "IMG_0263", "IMG_0278" ] }, { "action": "Ask about prior treatment, work impact and whether patient believes accident affected them; record all notes.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0244", "IMG_0263", "IMG_0278" ] }, { "action": "Send information to doctor and Billing; source suggests checking other occupants.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0244", "IMG_0263", "IMG_0278" ] }, { "action": "If relation of accident and symptoms is unclear, ask doctor to assess.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0244", "IMG_0263", "IMG_0278" ] }, { "action": "Review claim viability with doctor and verified payer information rather than assuming coverage.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0244", "IMG_0263", "IMG_0278" ] } ] **branches** [] **completion** "Accident history, clinical review and billing documents routed; no automatic causation claim." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [ "rec-auto-example-archive" ] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "Historical Utah minimums, subrogation and four-year claim statements require fresh legal/payer verification." ] **clinicalBoundary** "The book’s “AT FAULT” explanation is internally confusing; do not implement as a legal rule. The puppy analogy does not establish injury or coverage." ### rec-workers-comp · Work-injury intake and payer prerequisites Sources: IMG_0244, IMG_0263, IMG_0279 Trigger: Patient reports a work-related incident Owner: Enrollment / Billing Purpose: Work-injury intake and payer prerequisites **preconditions** [] **steps** [ { "action": "Complete workers-comp paperwork and clear narrative of what happened.", "owner": "Enrollment / Billing", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0244", "IMG_0263", "IMG_0279" ] }, { "action": "Ask whether incident was reported to supervisor and whether employer requires Work Med/another facility first.", "owner": "Enrollment / Billing", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0244", "IMG_0263", "IMG_0279" ] }, { "action": "Refer questions to doctor; supply Billing all necessary material.", "owner": "Enrollment / Billing", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0244", "IMG_0263", "IMG_0279" ] }, { "action": "Once billing prerequisites are satisfied, complete Day 3 paperwork and office flow.", "owner": "Enrollment / Billing", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0244", "IMG_0263", "IMG_0279" ] } ] **branches** [] **completion** "Required reports, employer/payer pathway and billing readiness documented." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "The book claims 6–12 visits and one doctor change in Utah; treat as historical statements requiring verification." ] **clinicalBoundary** "Do not repeat the source’s disparaging insurer claim or treat old legal/coverage rules as current." ### rec-claim-transition · Replace the financial arrangement when accident coverage ends Sources: IMG_0279 Trigger: Auto or workers-comp coverage/case ends while continued care is considered Owner: Enrollment / Billing / Doctor Purpose: Replace the financial arrangement when accident coverage ends **preconditions** [] **steps** [ { "action": "Identify the end of auto/work-comp arrangement.", "owner": "Enrollment / Billing / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0279" ] }, { "action": "Create a new financial for continued care based on actual new coverage and clinician recommendation.", "owner": "Enrollment / Billing / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0279" ] }, { "action": "Complete agreed paperwork and update record markings.", "owner": "Enrollment / Billing / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0279" ] } ] **branches** [] **completion** "New arrangement accepted or patient’s other disposition recorded; no stale claim used." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." }, { "action": "A claim-close or benefits-end event creates a dependency on clinician recommendation and new financial review before future charges.", "basis": "inferred", "rationale": "Closes a source-explicit transition that can otherwise be overlooked." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [] **clinicalBoundary** "Clinical decisions remain with the treating clinician; scheduling and task orchestration do not establish medical necessity." ### rec-frontdesk-shift · Front-desk opening, lunch and closing control Sources: IMG_0239, IMG_0240, IMG_0241, IMG_0245, IMG_0250, IMG_0260, IMG_0290 Trigger: Start, midpoint and end of each clinic shift Owner: Front Desk Manager Purpose: Front-desk opening, lunch and closing control **preconditions** [] **steps** [ { "action": "Start huddle on time with required personnel; review manual/computer books for expected concerns and distribute messages.", "owner": "Reception / Doctor", "timing": "Opening", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0240", "IMG_0241", "IMG_0245", "IMG_0250", "IMG_0260", "IMG_0290" ] }, { "action": "Pull travel cards, call missed appointments, clear Pending, transfer phones and review misses with doctor.", "owner": "Reception", "timing": "Before lunch", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0240", "IMG_0241", "IMG_0245", "IMG_0250", "IMG_0260", "IMG_0290" ] }, { "action": "Complete doctor call list, NP log, tomorrow’s cards/books, missed calls and missed-Day-1 log.", "owner": "Reception", "timing": "End of day", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0240", "IMG_0241", "IMG_0245", "IMG_0250", "IMG_0260", "IMG_0290" ] }, { "action": "Review both books with doctor: nonhighlighted no-shows and written-in walk-ins; investigate unmarked outcomes.", "owner": "Reception / Doctor", "timing": "End of each shift", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0240", "IMG_0241", "IMG_0245", "IMG_0250", "IMG_0260", "IMG_0290" ] }, { "action": "Verify live phone coverage, clear Pending and reconcile Cash Practice report, payment log, payments and receipts.", "owner": "Reception", "timing": "End of day", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0240", "IMG_0241", "IMG_0245", "IMG_0250", "IMG_0260", "IMG_0290" ] } ] **branches** [] **completion** "Signed shift checklist; incomplete items have named next owner and remain visible." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." }, { "action": "Create an exception-focused huddle view with no-shows, walk-ins, unscheduled next stages, Pending and unsigned handoffs.", "basis": "inferred", "rationale": "Replicates the book’s deliberate cross-checks." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [] **clinicalBoundary** "Clinical decisions remain with the treating clinician; scheduling and task orchestration do not establish medical necessity." ### rec-enrollment-shift · Enrollment readiness and completion control Sources: IMG_0265, IMG_0269, IMG_0270, IMG_0282 Trigger: Each Enrollment shift Owner: Enrollment Purpose: Enrollment readiness and completion control **preconditions** [] **steps** [ { "action": "Clock in and be ready five minutes before huddle.", "owner": "Enrollment", "timing": "Before huddle", "basis": "book", "sourcePhotos": [ "IMG_0265", "IMG_0269", "IMG_0270", "IMG_0282" ] }, { "action": "Prepare finances, films and files for next shift; avoid double booking and have someone ready for each patient.", "owner": "Enrollment", "timing": "End of preceding shift", "basis": "book", "sourcePhotos": [ "IMG_0265", "IMG_0269", "IMG_0270", "IMG_0282" ] }, { "action": "Take Day 1/2/3 patients into room within ten minutes after paperwork/pamphlets completed.", "owner": "Enrollment", "timing": "At visit", "basis": "book", "sourcePhotos": [ "IMG_0265", "IMG_0269", "IMG_0270", "IMG_0282" ] }, { "action": "Keep NP checklist/log, calendar/financial markings and completed Quality files accurate; Day 3 family/flow/rehab tasks complete.", "owner": "Enrollment", "timing": "Daily", "basis": "book", "sourcePhotos": [ "IMG_0265", "IMG_0269", "IMG_0270", "IMG_0282" ] }, { "action": "Use free time for new patients, ROF scheduling and paperwork; review unresolved Day 2/3 stacks and missed-stage recovery.", "owner": "Enrollment", "timing": "Available time", "basis": "book", "sourcePhotos": [ "IMG_0265", "IMG_0269", "IMG_0270", "IMG_0282" ] }, { "action": "Record audits, audit meetings, Day 1 scheduled/performed, ROF, re-signs, starts, start %, recovery counts, OTC and bonus records.", "owner": "Enrollment", "timing": "End of day", "basis": "book", "sourcePhotos": [ "IMG_0265", "IMG_0269", "IMG_0270", "IMG_0282" ] } ] **branches** [] **completion** "Readiness checklist and stats entered; any unreconciled file or stage remains assigned." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [] **clinicalBoundary** "Clinical decisions remain with the treating clinician; scheduling and task orchestration do not establish medical necessity." ### rec-weekly-targets · Weekly patient-visit and Enrollment performance review Sources: IMG_0239, IMG_0242, IMG_0260, IMG_0269, IMG_0270, IMG_0280 Trigger: End of week planning cycle Owner: Front Desk Manager / Enrollment / Office Manager Purpose: Weekly patient-visit and Enrollment performance review **preconditions** [] **steps** [ { "action": "Post next week’s quota graphs and battle plans; print Saturday recall appointments.", "owner": "Front Desk Manager / Enrollment / Office Manager", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0242", "IMG_0260", "IMG_0269", "IMG_0270", "IMG_0280" ] }, { "action": "Friday calculate next-week PV scheduling gap as target minus booked visits plus 10% of target.", "owner": "Front Desk Manager / Enrollment / Office Manager", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0242", "IMG_0260", "IMG_0269", "IMG_0270", "IMG_0280" ] }, { "action": "Record patient visits last/current week, reactivations and daily petty cash.", "owner": "Front Desk Manager / Enrollment / Office Manager", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0242", "IMG_0260", "IMG_0269", "IMG_0270", "IMG_0280" ] }, { "action": "Enrollment records starts and re-signs; source targets above 70% of new patients starting and above 70% of eligible patients re-signing.", "owner": "Front Desk Manager / Enrollment / Office Manager", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0242", "IMG_0260", "IMG_0269", "IMG_0270", "IMG_0280" ] }, { "action": "Send complete performance sheet to Div 7/manager mailbox; Enrollment includes weekly summary and help needed.", "owner": "Front Desk Manager / Enrollment / Office Manager", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0239", "IMG_0242", "IMG_0260", "IMG_0269", "IMG_0270", "IMG_0280" ] } ] **branches** [] **completion** "Targets, gap calculation, actual metrics and management-review submission visible." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "Denominators for start/re-sign percentages, cohort dates, refunds and cancellations are not fully specified.", "Do not infer negative gap handling from the formula." ] **clinicalBoundary** "Operational targets must not decide individual clinical necessity or pressure patients to accept care." ### rec-training · Enrollment competency pass-offs and supervised readiness Sources: IMG_0266, IMG_0280, IMG_0281 Trigger: New Enrollment employee hired or role needs competency refresh Owner: Senior / Trainer Purpose: Enrollment competency pass-offs and supervised readiness **preconditions** [] **steps** [ { "action": "Review and agree performance expectations; tour, staff introduction, desk/manual and signed policies.", "owner": "Senior / Trainer", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0266", "IMG_0280", "IMG_0281" ] }, { "action": "Teach Primary Script and schedule three new-patient-ins from survey, referral card or massage patient.", "owner": "Senior / Trainer", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0266", "IMG_0280", "IMG_0281" ] }, { "action": "Explain Post, Hat, Hatted, Product, Statistics and Passing of hat; conditions/formulas Non-existence, Danger, Emergency, Normal and Affluence; perform Non-existence formula.", "owner": "Senior / Trainer", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0266", "IMG_0280", "IMG_0281" ] }, { "action": "Pass off travel-card responsibility, full Day 1, financial paperwork/verbal, Day 3, rehab equipment, C2/T2/L2 imaging and missed-stage/reception/recall phones.", "owner": "Senior / Trainer", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0266", "IMG_0280", "IMG_0281" ] }, { "action": "Pass off NP log/checklist, Room 4, re-exams, privacy certification and requirements before file/travel-card separation.", "owner": "Senior / Trainer", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0266", "IMG_0280", "IMG_0281" ] }, { "action": "Set OTC and Day 1/2/3 quota graphs; demonstrate source NORMAL graph for four weeks; senior dates/signs readiness.", "owner": "Senior / Trainer", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0266", "IMG_0280", "IMG_0281" ] } ] **branches** [] **completion** "Each competency has trainer signoff, observed evidence and any scope restriction documented." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [ "care-primary-script", "grow-primary", "grow-primary-alt" ] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "Organizational terms/formulas referenced here require their full source sections elsewhere; headings alone on IMG_0281 do not define them." ] **clinicalBoundary** "Training checklist does not grant authority to perform exams or x-rays. Credentials, scope and supervision must be verified before role permissions." ### rec-supplies · Prepare imaging supplies, forms and portfolios Sources: IMG_0282 Trigger: Each shift preparation or stock becomes low Owner: Enrollment Purpose: Prepare imaging supplies, forms and portfolios **preconditions** [] **steps** [ { "action": "Ensure adequate fresh cassettes/film and process when supply is doubtful.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0282" ] }, { "action": "Record low x-ray film, envelopes, tags, developer and fixer on supply-closet-door list.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0282" ] }, { "action": "Keep extra forms in each portfolio; copy from original only and ensure crisp clean forms.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0282" ] } ] **branches** [] **completion** "Supplies request and portfolio readiness documented." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." }, { "action": "Convert supply-door notes to assigned replenishment tasks; version-control approved master forms.", "basis": "inferred", "rationale": "Preserves the source instruction to use originals and never miss stock shortages." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "The book uses film-era equipment; a digital-imaging supply list requires current-clinic inventory." ] **clinicalBoundary** "Clinical decisions remain with the treating clinician; scheduling and task orchestration do not establish medical necessity." ### rec-task-handoff · Position task calendar and absence handoff Sources: IMG_0245, IMG_0282 Trigger: A task is created, remains incomplete or a person covers the role Owner: Each role holder Purpose: Position task calendar and absence handoff **preconditions** [] **steps** [ { "action": "Keep a desk calendar specific to the position; write tasks on their due days.", "owner": "Each role holder", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0245", "IMG_0282" ] }, { "action": "Check it every day, mark completed tasks and move incomplete tasks to the next day.", "owner": "Each role holder", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0245", "IMG_0282" ] }, { "action": "Covering personnel consult both appointment book and desk calendar.", "owner": "Each role holder", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0245", "IMG_0282" ] }, { "action": "Empty communication-center mailbox at least twice each shift.", "owner": "Each role holder", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0245", "IMG_0282" ] }, { "action": "Use Pending slot for busy-hour entries and obtain team help to clear before leaving.", "owner": "Each role holder", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0245", "IMG_0282" ] } ] **branches** [] **completion** "Every incomplete item retains a visible owner, due date and follow-up; cover staff can find role work." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." }, { "action": "Keep original due date and overdue age when rolling a task forward; require reason and next owner.", "basis": "inferred", "rationale": "Strengthens the book’s carry-forward rule without hiding accumulating overdue work." }, { "action": "Route task links and scripts by role; require acknowledgement on handoff.", "basis": "inferred", "rationale": "Digital equivalent of position calendar, mailbox and Pending." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [] **clinicalBoundary** "Clinical decisions remain with the treating clinician; scheduling and task orchestration do not establish medical necessity." ### rec-policies-consent · Review and sign policies and informed consent Sources: IMG_0261, IMG_0275, IMG_0284, IMG_0286, IMG_0287 Trigger: Before care and before financial arrangement acceptance Owner: Enrollment / Doctor Purpose: Review and sign policies and informed consent **preconditions** [] **steps** [ { "action": "Provide policy discussion covering financial terms, exercises, workshops, insurance changes, discontinuation, family invitations and appointments.", "owner": "Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0261", "IMG_0275", "IMG_0284", "IMG_0286", "IMG_0287" ] }, { "action": "Doctor completes health history/exam, assesses need for further studies/modification/referral, reports findings and plan before care.", "owner": "Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0261", "IMG_0275", "IMG_0284", "IMG_0286", "IMG_0287" ] }, { "action": "Document patient/legal guardian name, relationship, signature/date and witness for consent; policy form has patient/staff signature/date and payment fields.", "owner": "Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0261", "IMG_0275", "IMG_0284", "IMG_0286", "IMG_0287" ] }, { "action": "Notify office when insurance changes or auto/work injury occurs; review any changed financial arrangement.", "owner": "Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0261", "IMG_0275", "IMG_0284", "IMG_0286", "IMG_0287" ] } ] **branches** [] **completion** "Current approved version signed with documented questions and clinician review; source originals remain identifiable." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [ "rec-patient-policies", "rec-informed-consent" ] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "Historical forms require current approval; this proposal is not verification of their legal sufficiency.", "IMG_0284 Care Credit clause is marked with an X; do not assume active." ] **clinicalBoundary** "Old complication rates and unrelated risk comparisons are not validated. No automatic delivery of minimization claims, vaccine claims or mandatory treatment for family members." ### rec-mini-day2 · Mini Day 2 before the full Report of Findings Sources: IMG_0285 Trigger: Clinician will adjust on Day 1 or before the full ROF Owner: Doctor / Reception Purpose: Mini Day 2 before the full Report of Findings **preconditions** [] **steps** [ { "action": "Ensure doctor has seen the x-rays and knows insurance-verification result; source says films are not shown to patient at this mini visit.", "owner": "Doctor / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0285" ] }, { "action": "Place patient in room and notify doctor.", "owner": "Doctor / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0285" ] }, { "action": "Doctor briefly describes findings, provides appropriate adjustment and confirms or sets full ROF.", "owner": "Doctor / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0285" ] }, { "action": "Doctor escorts patient to front desk for next appointment.", "owner": "Doctor / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0285" ] } ] **branches** [] **completion** "Clinical visit documented and full ROF remains booked or assigned as unresolved." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [] **clinicalBoundary** "This pathway never bypasses informed consent or clinician assessment. “Do not show films” does not justify withholding requested information." ### rec-doctor-delivery · Doctor preparation, treatment review and patient concerns Sources: IMG_0289, IMG_0290 Trigger: Before and during each treating shift Owner: Doctor Purpose: Doctor preparation, treatment review and patient concerns **preconditions** [] **steps** [ { "action": "Prepare marked films and planned discussions before shift; note travel-card corrections and concerned/missing patients.", "owner": "Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0289", "IMG_0290" ] }, { "action": "Know patient expectations and current calendar; review adherence and progress during visits.", "owner": "Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0289", "IMG_0290" ] }, { "action": "Within first three visits source expects improvement; if progress is lacking review frequency/technique or otherwise reassess clinically.", "owner": "Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0289", "IMG_0290" ] }, { "action": "When agreement, progress or calendar is uncertain arrange special consultation.", "owner": "Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0289", "IMG_0290" ] }, { "action": "Teach office flow, table/card return and prescribed exercises; review missed appointments with Reception at each shift end.", "owner": "Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0289", "IMG_0290" ] } ] **branches** [] **completion** "Clinical progress and concern disposition documented; operational handoffs acknowledged." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "Personal routines (bed 10pm, wake 5:30am M/W/F, goals three times daily, motivational audio/mantras) are source coaching, not mandatory patient automation." ] **clinicalBoundary** "No guarantee of “miracles,” no automatic treatment-frequency increase and no source assertion that patients do not need medical care. Patient-reported outcomes and appropriate medical referral remain central." ### rec-education · Ongoing patient education and workshop planning Sources: IMG_0273, IMG_0275, IMG_0284, IMG_0291 Trigger: Weekly handout cycle and monthly workshop cycle Owner: Doctor Purpose: Ongoing patient education and workshop planning **preconditions** [] **steps** [ { "action": "Create a new handout Monday/Wednesday/Friday in the source model.", "owner": "Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0273", "IMG_0275", "IMG_0284", "IMG_0291" ] }, { "action": "Choose daily table-topic, often tied to handout, and discuss progress and remaining issues.", "owner": "Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0273", "IMG_0275", "IMG_0284", "IMG_0291" ] }, { "action": "Teach one of four talks each month: Patient Orientation, Nutrition, Exercise, Stress/Time management.", "owner": "Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0273", "IMG_0275", "IMG_0284", "IMG_0291" ] }, { "action": "Track source health-care-class recommendation and attendance opportunities without losing follow-up.", "owner": "Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0273", "IMG_0275", "IMG_0284", "IMG_0291" ] } ] **branches** [] **completion** "Reviewed content, planned talk, delivery/attendance and patient questions logged." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "No exact workshop invitation or nonattendance sequence is provided; any reminders are proposed additions." ] **clinicalBoundary** "Source includes anti-medical, vaccine and health claims. Keep archival wording but require clinician-reviewed, evidence-based content; never discourage necessary medical care or override patient reports." ### rec-collections-ledger · Daily reception collections and patient-visit ledger Sources: IMG_0238, IMG_0239, IMG_0260, IMG_0269 Trigger: End of reception day, week or month Owner: Reception / Enrollment Purpose: Daily reception collections and patient-visit ledger **preconditions** [] **steps** [ { "action": "Record month/year and receptionist identity; separate cash/check, credit card, total OTC collections and patient visits by day.", "owner": "Reception / Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0238", "IMG_0239", "IMG_0260", "IMG_0269" ] }, { "action": "Sum weekly rows and monthly totals; retain corrections visibly.", "owner": "Reception / Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0238", "IMG_0239", "IMG_0260", "IMG_0269" ] }, { "action": "Reconcile ledger to receipts/payment logs and role performance records.", "owner": "Reception / Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0238", "IMG_0239", "IMG_0260", "IMG_0269" ] } ] **branches** [] **completion** "Daily entries reconcile, period totals reviewed and correction trail retained." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." }, { "action": "Compute totals from accepted transactions and reconcile source corrections instead of copying handwritten arithmetic blindly.", "basis": "inferred", "rationale": "Preserves the reporting function without treating uncertain example totals as facts." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "IMG_0238 has crossed-out and marginal totals; it is an example ledger, not a verified financial statement." ] **clinicalBoundary** "Clinical decisions remain with the treating clinician; scheduling and task orchestration do not establish medical necessity." ### rec-marketing-call · Call a survey, referral-card or other marketing lead Sources: IMG_0247, IMG_0266 Trigger: Permission-eligible lead from stress survey, 3x5 card, referral or massage context Owner: Reception / Enrollment Purpose: Call a survey, referral-card or other marketing lead **preconditions** [] **steps** [ { "action": "Use the person’s name and explain why calling; introduction differs by lead source.", "owner": "Reception / Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0247", "IMG_0266" ] }, { "action": "Use the same Primary Script after the introduction.", "owner": "Reception / Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0247", "IMG_0266" ] }, { "action": "Agree appointment and record source; new Enrollment trainee demonstrates this with three scheduled NPIs.", "owner": "Reception / Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0247", "IMG_0266" ] } ] **branches** [] **completion** "Lead has recorded source, permission status, call outcome and appointment or explicit next disposition." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [ "care-primary-script", "grow-primary", "grow-primary-alt" ] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "This segment supplies no fixed nurture cadence for marketing leads." ] **clinicalBoundary** "Do not pretend to know an unfamiliar person or imply permission that does not exist. Referral outreach must satisfy the explicit permission instruction on IMG_0276." ### rec-family-invitation · Track the family invitation through scheduling and attendance Sources: IMG_0235, IMG_0246, IMG_0255, IMG_0261, IMG_0265, IMG_0270, IMG_0275, IMG_0280, IMG_0284 Trigger: Patient begins care and family discussion occurs Owner: Enrollment / Reception Purpose: Track the family invitation through scheduling and attendance **preconditions** [] **steps** [ { "action": "At new-patient inquiry ask whether appointment is for the person or whole family.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0235", "IMG_0246", "IMG_0255", "IMG_0261", "IMG_0265", "IMG_0270", "IMG_0275", "IMG_0280", "IMG_0284" ] }, { "action": "At ROF and by Day3 discuss family invitation and record whom the patient wishes to invite.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0235", "IMG_0246", "IMG_0255", "IMG_0261", "IMG_0265", "IMG_0270", "IMG_0275", "IMG_0280", "IMG_0284" ] }, { "action": "Source policy calls for children to be checked within two weeks of a parent starting, at doctor’s expense.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0235", "IMG_0246", "IMG_0255", "IMG_0261", "IMG_0265", "IMG_0270", "IMG_0275", "IMG_0280", "IMG_0284" ] }, { "action": "Record family scheduling on Day3 routing form.", "owner": "Enrollment / Reception", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0235", "IMG_0246", "IMG_0255", "IMG_0261", "IMG_0265", "IMG_0270", "IMG_0275", "IMG_0280", "IMG_0284" ] } ] **branches** [] **completion** "Invitation delivered; each invited person’s consent and scheduled/declined/pending outcome recorded." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." }, { "action": "Create a proposed Day3 scheduling check and two-week unresolved-invitation review, with no diagnosis or assumption that family needs treatment.", "basis": "inferred", "rationale": "Preserves source timing while allowing informed choice and preventing a forgotten invitation." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "Source does not prescribe an exact unbooked-family reminder cadence or clinical screening criteria." ] **clinicalBoundary** "Each adult or guardian must consent individually. A mandatory family examination is not an automated obligation; determine appropriateness clinically." ### rec-rehab-handoff · Demonstrate and record prescribed rehabilitation Sources: IMG_0256, IMG_0261, IMG_0266, IMG_0273, IMG_0275, IMG_0284 Trigger: Clinician prescribes exercises/equipment and patient reaches Day3 or revised plan Owner: Enrollment / qualified treatment staff Purpose: Demonstrate and record prescribed rehabilitation **preconditions** [] **steps** [ { "action": "Demonstrate office flow and prescribed rehabilitation exercises.", "owner": "Enrollment / qualified treatment staff", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0256", "IMG_0261", "IMG_0266", "IMG_0273", "IMG_0275", "IMG_0284" ] }, { "action": "Provide agreed equipment and record exercises shown, equipment given and photograph field on routing form.", "owner": "Enrollment / qualified treatment staff", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0256", "IMG_0261", "IMG_0266", "IMG_0273", "IMG_0275", "IMG_0284" ] }, { "action": "Source policy gives twice daily for at least fifteen minutes each time; actual prescription remains clinician-specific.", "owner": "Enrollment / qualified treatment staff", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0256", "IMG_0261", "IMG_0266", "IMG_0273", "IMG_0275", "IMG_0284" ] }, { "action": "Verify training pass-off for staff demonstrating equipment.", "owner": "Enrollment / qualified treatment staff", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0256", "IMG_0261", "IMG_0266", "IMG_0273", "IMG_0275", "IMG_0284" ] } ] **branches** [] **completion** "Patient received demonstration and actual prescription; equipment and understanding documented." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." }, { "action": "Provide a secure clinician-approved exercise link and optional consented reminders matched to actual prescription.", "basis": "inferred", "rationale": "Digitizes the stated home-care instruction without inventing clinical content." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "No specific exercise set or missed-home-exercise escalation is in these pages." ] **clinicalBoundary** "Do not automatically prescribe a generic twice-daily regimen or infer patient capability. New symptoms or difficulty require clinician review." ### rec-plan-end-review · Review end-of-plan and re-sign opportunities Sources: IMG_0251, IMG_0265, IMG_0267, IMG_0269, IMG_0280 Trigger: EOC or last scheduled visit approaches, or audit identifies a completed plan Owner: Enrollment / Doctor Purpose: Review end-of-plan and re-sign opportunities **preconditions** [] **steps** [ { "action": "Identify EOC and LA distinctly; LA means no further booked appointments, not necessarily clinical completion.", "owner": "Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0251", "IMG_0265", "IMG_0267", "IMG_0269", "IMG_0280" ] }, { "action": "Review active status, payment history, prior recommendation and possible re-sign opportunity.", "owner": "Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0251", "IMG_0265", "IMG_0267", "IMG_0269", "IMG_0280" ] }, { "action": "Obtain doctor’s current recommendation and discuss patient preference before a new financial.", "owner": "Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0251", "IMG_0265", "IMG_0267", "IMG_0269", "IMG_0280" ] }, { "action": "Record re-sign outcome and source re-sign metric.", "owner": "Enrollment / Doctor", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0251", "IMG_0265", "IMG_0267", "IMG_0269", "IMG_0280" ] } ] **branches** [] **completion** "Clinical disposition, patient choice and financial/appointment next steps explicit." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." }, { "action": "Generate an owner task when EOC/LA is reached with no documented disposition; link clinician reassessment and financial audit.", "basis": "inferred", "rationale": "Prevents both accidental abandonment and automatic renewal." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "No exact advance lead-time for end-of-plan review is specified here.", "Source target over70% re-sign is a business measure, not clinical eligibility." ] **clinicalBoundary** "Never auto-renew treatment or payment just because an operational target exists. Continued care requires clinical indication and patient authorization." ### rec-insurance-change · Handle changed insurance before using stale financials Sources: IMG_0258, IMG_0259, IMG_0267, IMG_0284, IMG_0288 Trigger: Patient reports changed insurance or a plan-year boundary affects verified benefits Owner: Billing / Enrollment Purpose: Handle changed insurance before using stale financials **preconditions** [] **steps** [ { "action": "Collect patient-reported insurance change and new insurer information.", "owner": "Billing / Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0258", "IMG_0259", "IMG_0267", "IMG_0284", "IMG_0288" ] }, { "action": "Billing verifies applicable benefits, limits and year basis.", "owner": "Billing / Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0258", "IMG_0259", "IMG_0267", "IMG_0284", "IMG_0288" ] }, { "action": "Enrollment uses current verification with clinician recommendation to update financial summary and travel-card/computer arrangements.", "owner": "Billing / Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0258", "IMG_0259", "IMG_0267", "IMG_0284", "IMG_0288" ] } ] **branches** [] **completion** "Current benefits and approved revised arrangement documented; previous terms version retained." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." }, { "action": "Treat an insurance-change event as an explicit verification dependency and notify Enrollment of changed financial assumptions.", "basis": "inferred", "rationale": "Connects source notification obligation to its existing verification and financial process." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "The book obligates patients to notify insurance changes but gives no exact reverification cadence." ] **clinicalBoundary** "Do not guarantee payer coverage or automatically alter charges without required agreement." ### rec-discontinuation · Document voluntary discontinuation or clinician discharge Sources: IMG_0249, IMG_0267, IMG_0284 Trigger: Patient chooses to discontinue or clinician determines discharge Owner: Doctor / Enrollment Purpose: Document voluntary discontinuation or clinician discharge **preconditions** [] **steps** [ { "action": "Ask candid feedback and identify whether any concern can be resolved; record decision without erasing the reason.", "owner": "Doctor / Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0249", "IMG_0267", "IMG_0284" ] }, { "action": "Review delivered services, actual payments and original arrangement in a financial audit.", "owner": "Doctor / Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0249", "IMG_0267", "IMG_0284" ] }, { "action": "Source policy describes immediate outstanding balance and normal-fee recalculation without one-time discount; source Care Credit refund term is crossed at item number. Preserve these as unapproved historical terms.", "owner": "Doctor / Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0249", "IMG_0267", "IMG_0284" ] }, { "action": "Determine current approved financial disposition and required clinical handoff.", "owner": "Doctor / Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0249", "IMG_0267", "IMG_0284" ] } ] **branches** [] **completion** "Reason, clinician disposition, outreach preference and approved account resolution recorded." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." }, { "action": "Stop routine attendance/renewal marketing sequences on documented discontinuation, retain only appropriate agreed account or clinical handoff tasks.", "basis": "inferred", "rationale": "Avoids treating an explicit decision as an unreachable lead." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "Clinical discharge/referral process and current refund rules are not specified.", "Crossed Care Credit clause is ambiguous; no automatic use." ] **clinicalBoundary** "Patient can decline care; financial terms need current review and must not block appropriate clinical referral or access to required information." ### rec-patient-relations · Maintain patient relationship communications Sources: IMG_0280, IMG_0291 Trigger: Role-owned patient relations activity is planned Owner: Enrollment Purpose: Maintain patient relationship communications **preconditions** [] **steps** [ { "action": "Maintain mailing list, patient letters, gifts, cards, reactivation and newsletter.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0280", "IMG_0291" ] }, { "action": "Coordinate approved education and workshop information with doctor.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0280", "IMG_0291" ] }, { "action": "Track reactivated patients as the listed patient-relations statistic.", "owner": "Enrollment", "timing": "At this stage", "basis": "book", "sourcePhotos": [ "IMG_0280", "IMG_0291" ] } ] **branches** [] **completion** "Each approved communication has defined audience, content owner and outcome; no unowned mailing task." **stopConditions** [ "Completed and next action assigned.", "Inferred: explicit patient refusal, withdrawn contact permission or safety concern pauses routine outreach and routes a human review." ] **escalation** [ "Inferred: overdue or unowned work appears on the role lead exception queue; urgency and escalation interval require policy approval." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with due time, source-page link, linked script, completion evidence and an overdue exception visible to the role lead.", "basis": "inferred", "rationale": "Digitizes the source checklist and its handoff without pretending the book specifies software behavior." }, { "action": "Provide a content calendar with approved audience permissions and links to reviewed scripts/handouts.", "basis": "inferred", "rationale": "Makes listed duties operational without inventing the author’s missing timing." } ] **states** [ "Due", "Assigned", "In progress", "Waiting on dependency", "Completed", "Exception" ] **gaps** [ "Source lists these functions but provides no newsletter frequency, birthdays or event-trigger details in this segment. Any such schedule is a proposed addition." ] **clinicalBoundary** "Do not include patient conditions in public communications or distribute unreviewed historical medical claims." ### care-doctor-day · Doctor day, huddles and end-of-shift reconciliation Sources: IMG_0292, IMG_0319, IMG_0320, IMG_0321 Trigger: A treatment shift opens, closes or reaches its huddle time Owner: Treating doctor Purpose: Convert the doctor checklist into assigned daily work with explicit closure. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Arrive at front desk prepared; have weekly handout, visible quota graph/battle plan and room ready.", "owner": "Doctor", "timing": "7:25 source office time", "sourcePhotos": [ "IMG_0292", "IMG_0319" ], "basis": "book" }, { "action": "Huddle on responsibilities, films, financials and ready rooms.", "owner": "Whole team", "timing": "7:30 and 2:30", "sourcePhotos": [ "IMG_0319" ], "basis": "book" }, { "action": "Use adjusting blocks for education, adjustment, films and Day 1/2; capture problems and arrange SCs.", "owner": "Doctor", "timing": "8–11 and 2:55–6, source schedule", "sourcePhotos": [ "IMG_0319" ], "basis": "book" }, { "action": "Use non-adjusting blocks for 10–15-minute SCs, calls and paperwork.", "owner": "Doctor", "timing": "11–12 and 1–2:30", "sourcePhotos": [ "IMG_0319" ], "basis": "book" }, { "action": "Review every missed appointment with reception; investigate any missing annotation.", "owner": "Doctor + receptionist", "timing": "Each shift end", "sourcePhotos": [ "IMG_0292", "IMG_0320" ], "basis": "book" }, { "action": "Complete call list, mark films, finish Dr. Use Forms for billing and pull next-shift films.", "owner": "Doctor", "timing": "Before leaving", "sourcePhotos": [ "IMG_0292", "IMG_0319" ], "basis": "book" } ] **branches** [ { "condition": "No patients in block", "action": "Train, study, practise skills and mark films while remaining available.", "owner": "Doctor", "timing": "During gap", "nextState": "productive downtime", "basis": "book", "sourcePhotos": [ "IMG_0292", "IMG_0319", "IMG_0320", "IMG_0321" ] } ] **completion** "Shift checklist signed; every missed appointment and capture item has a documented disposition; next-shift materials prepared." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: unresolved items remain assigned and appear in next huddle; no silent carryover." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned doctor day, huddles and end-of-shift reconciliation task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "preparing", "huddle ready", "treating", "reconciling", "closed" ] **gaps** [ "Exact office schedule is historical and must be configured.", "No source staff absence/backup routing is supplied." ] **clinicalBoundary** "" ### care-doctor-call-list · Doctor-only concerns and evening callback queue Sources: IMG_0292, IMG_0295 Trigger: Reception identifies a concern only doctor can address Owner: Doctor; receptionist captures and reconciles Purpose: Close the receptionist-to-clinician handoff for concerns, first adjustments and special situations. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Capture name, phone and specific concern on Dr. Call List.", "owner": "Receptionist", "timing": "During day", "sourcePhotos": [ "IMG_0295" ], "basis": "book" }, { "action": "Call every listed patient/referring party and annotate outcome.", "owner": "Doctor", "timing": "That night / before leaving", "sourcePhotos": [ "IMG_0295" ], "basis": "book" }, { "action": "Return annotated list so reception records what happened.", "owner": "Doctor then receptionist", "timing": "Next day", "sourcePhotos": [ "IMG_0295" ], "basis": "book" }, { "action": "Copy unresolved item for continued followup; retain ownership.", "owner": "Doctor", "timing": "By next day if unresolved", "sourcePhotos": [ "IMG_0295" ], "basis": "book" } ] **branches** [ { "condition": "Issue is birth, bereavement, intention to leave or other special situation", "action": "Doctor addresses the specific situation.", "owner": "Doctor", "timing": "That night", "nextState": "handled or continuing", "basis": "book", "sourcePhotos": [ "IMG_0292", "IMG_0295" ] }, { "condition": "Not resolved by next day", "action": "Keep copied work for later handling and return original with status.", "owner": "Doctor", "timing": "Next day", "nextState": "continuing", "basis": "book", "sourcePhotos": [ "IMG_0292", "IMG_0295" ] } ] **completion** "Reception has the annotated doctor outcomes and has reconciled the list. Returning the list can complete the daily handoff, but every unanswered or unresolved patient concern remains open with a named doctor and next action; it is not marked resolved merely because a call was attempted." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned doctor-only concerns and evening callback queue task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "captured", "due tonight", "attempted", "resolved", "continuing" ] **gaps** [ "Source gives no no-answer retry count or cadence." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders." ### care-first-adjustment-call · Same-day first-adjustment followup Sources: IMG_0295 Trigger: First adjustment completed Owner: Treating doctor Purpose: Discover response and concerns after the first adjustment, with clinician-owned next step. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Put patient name and phone numbers on doctor call list.", "owner": "Receptionist", "timing": "After first adjustment", "sourcePhotos": [ "IMG_0295" ], "basis": "book" }, { "action": "Call and ask how patient responded.", "owner": "Doctor", "timing": "Before leaving same day", "sourcePhotos": [ "IMG_0295" ], "basis": "book" }, { "action": "Document response and clinical instructions; confirm next appointment.", "owner": "Doctor", "timing": "During call", "sourcePhotos": [ "IMG_0295" ], "basis": "book" } ] **branches** [ { "condition": "Reports doing well", "action": "Use good-response close and confirm next visit.", "owner": "Doctor", "timing": "Same call", "nextState": "next visit confirmed", "basis": "book", "sourcePhotos": [ "IMG_0295" ] }, { "condition": "Reports doing poorly", "action": "Assess symptoms and determine care/instructions; source proposes overnight instructions and next-day appointment, including closed day.", "owner": "Doctor", "timing": "Same call", "nextState": "clinician followup required", "basis": "book", "sourcePhotos": [ "IMG_0295" ] }, { "condition": "Patient is not reached", "action": "Record the attempted call without marking the response check resolved. Keep the unanswered check on the doctor-owned review queue with an explicit next action; choose any further contact under approved clinic policy rather than invent a source retry cadence.", "owner": "Doctor", "timing": "After the unsuccessful attempt; next review/contact timing is a doctor or approved-policy decision", "nextState": "unanswered response check open", "basis": "inferred", "sourcePhotos": [ "IMG_0295" ] } ] **completion** "The doctor has reviewed the patient’s reported response and documented the clinical plan/next visit, or has recorded an explicit appropriate final disposition. A logged no-answer attempt completes only an attempt subtask; the unanswered response check remains open and doctor-owned for review. The book gives no unreachable-patient retry cadence." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-first-adjustment-call" ] **proposedAutomation** [ { "action": "Create doctor call task at first-adjustment completion with same-day due time, script/source links and required outcome.", "basis": "inferred", "rationale": "Digitizes the explicit Dr. Call List assignment." }, { "action": "Propose an optional consented SMS announcing a pending callback or confirming its agreed appointment; retain the physician call.", "basis": "inferred", "rationale": "User-authorized modernization without substituting for prescribed call." } ] **states** [ "first adjustment complete", "call due", "attempted / unreached", "response reviewed", "followup arranged", "intentional disposition" ] **gaps** [ "No unreachable-patient cadence or triage/red-flag protocol supplied." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. Source toxin explanation is not an approved automatic reply." ### care-referral-thanks · Doctor thank-you to referring party Sources: IMG_0295 Trigger: New patient has an applicable referring party Owner: Doctor Purpose: Close the referral gratitude loop. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Reception lists referring party on doctor call list.", "owner": "Receptionist", "timing": "New-patient processing", "sourcePhotos": [ "IMG_0295" ], "basis": "book" }, { "action": "Call and thank referring party.", "owner": "Doctor", "timing": "That night via call list", "sourcePhotos": [ "IMG_0295" ], "basis": "book" }, { "action": "Return notes to reception.", "owner": "Doctor", "timing": "Next day", "sourcePhotos": [ "IMG_0295" ], "basis": "book" } ] **branches** [] **completion** "The referring party has been reached and thanked, or a documented decline/contact restriction provides an intentional closure. An unsuccessful attempt is recorded as an attempt subtask only; the gratitude followup remains owned with an approved next action or review, without disclosing patient health details or inventing retry spacing." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned doctor thank-you to referring party task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "referral recorded", "thank-you due", "thanked" ] **gaps** [ "No exact thank-you wording provided." ] **clinicalBoundary** "Respect patient information-sharing permissions; gratitude does not require clinical details." ### care-doctor-training · Doctor competency onboarding and signoff Sources: IMG_0292, IMG_0293 Trigger: New doctor begins training Owner: Senior/trainer and doctor Purpose: Make all chapter competencies and practice expectations visible and auditable. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Record doctor name/start date; read and agree to values, job description, expectations and policies.", "owner": "Doctor", "timing": "Training start", "sourcePhotos": [ "IMG_0293" ], "basis": "book" }, { "action": "Demonstrate all fourteen listed chapters: scripts/calls/card, Day1/2, RE/RR, imaging/form, rehab, visit flow, ROF, reports/billing, conditions/formulas, battle plan and terminology.", "owner": "Doctor + trainer", "timing": "During training", "sourcePhotos": [ "IMG_0293" ], "basis": "book" }, { "action": "Assess independent performance, not being bypassed by others.", "owner": "Senior", "timing": "Before certification", "sourcePhotos": [ "IMG_0293" ], "basis": "book" }, { "action": "Sign, print name, date completion and place form in employee file.", "owner": "Senior / administration", "timing": "When competent", "sourcePhotos": [ "IMG_0293" ], "basis": "book" } ] **branches** [] **completion** "Every competency has evidence and senior signoff, with employee-file record." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned doctor competency onboarding and signoff task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "assigned", "practising", "assessed", "signed off" ] **gaps** [ "Referenced chapters 12–14 and full values/policies require cross-part reference.", "Source lacks re-certification interval." ] **clinicalBoundary** "Role competence and training do not grant clinical licensure or scope." ### care-primary-booking · Primary script to evaluation booking Sources: IMG_0294, IMG_0332, IMG_0339, IMG_0344 Trigger: A prospect agrees to a health-concern conversation Owner: Trained marketer or doctor; receptionist Purpose: Guide concern discovery to a concrete appointment and complete reception handoff. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Discover concern and impact with permission, then explain potential help using approved version of source primary script.", "owner": "Caller", "timing": "Initial conversation", "sourcePhotos": [ "IMG_0294", "IMG_0339" ], "basis": "book" }, { "action": "Offer morning/afternoon, next two blocks and two available times.", "owner": "Caller", "timing": "Same conversation", "sourcePhotos": [ "IMG_0294", "IMG_0339" ], "basis": "book" }, { "action": "Give directions and ask whether any reason prevents keeping appointment.", "owner": "Caller", "timing": "Before closing", "sourcePhotos": [ "IMG_0294", "IMG_0339" ], "basis": "book" }, { "action": "Hand name, phone and referral source to receptionist for booking.", "owner": "Caller + receptionist", "timing": "Immediately after agreement", "sourcePhotos": [ "IMG_0294" ], "basis": "book" } ] **branches** [ { "condition": "Prospect expresses health concern needing clinical discussion", "action": "Route to doctor; do not make diagnosis.", "owner": "Marketer", "timing": "During conversation", "nextState": "doctor review", "basis": "inferred", "sourcePhotos": [ "IMG_0294", "IMG_0339", "IMG_0344" ] }, { "condition": "Prospect chooses time", "action": "Enter slot and capture attendance commitment.", "owner": "Receptionist", "timing": "At booking", "nextState": "evaluation booked", "basis": "book", "sourcePhotos": [ "IMG_0294", "IMG_0339", "IMG_0344" ] } ] **completion** "Real slot reserved with name, contact, source, directions and commitment outcome." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-primary-script", "care-marketing-booking" ] **proposedAutomation** [ { "action": "Use available schedule slots in script, create booking handoff, and send consented directions/confirmation link after the call.", "basis": "inferred", "rationale": "Modernizes manual appointment-book handoff while preserving the call." } ] **states** [ "concern discovered", "in conversation", "time selected", "evaluation booked" ] **gaps** [ "No source contact-consent capture, no-answer retry cadence or refusal closure given." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. Do not instruct stopping medication to test the source analogy." ### care-visit-loop · Every-visit preparation, explanation and next visit Sources: IMG_0296, IMG_0297, IMG_0300, IMG_0305, IMG_0306, IMG_0320, IMG_0321, IMG_0322, IMG_0324, IMG_0327, IMG_0330, IMG_0331, IMG_0332 Trigger: An active patient arrives for a treatment visit Owner: Treating doctor Purpose: Ensure regular visits leave a documented assessment, instructions and next commitment. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Review chief concern, films, technique and calendar before approaching; observe energy/concerns.", "owner": "Doctor", "timing": "At every visit", "sourcePhotos": [ "IMG_0296", "IMG_0300", "IMG_0320", "IMG_0324" ], "basis": "book" }, { "action": "Greet by name; assess and explain relevant findings/what will be done.", "owner": "Doctor", "timing": "During visit", "sourcePhotos": [ "IMG_0297", "IMG_0322" ], "basis": "book" }, { "action": "Provide clinically appropriate treatment and brief education; source flow begins face down with travel card available.", "owner": "Doctor", "timing": "During visit", "sourcePhotos": [ "IMG_0297", "IMG_0321", "IMG_0322" ], "basis": "book" }, { "action": "Give specific home care, rehab or calendar instructions and document response.", "owner": "Doctor", "timing": "Before exit", "sourcePhotos": [ "IMG_0297", "IMG_0300" ], "basis": "book" }, { "action": "Name next appointment; at third visit check remembered teaching and offer mini-report if unclear.", "owner": "Doctor", "timing": "Exit / third visit", "sourcePhotos": [ "IMG_0300", "IMG_0330" ], "basis": "book" }, { "action": "Route unresolved questions, pain, finances or commitment concerns to appropriate exception owner.", "owner": "Doctor", "timing": "Before completing visit", "sourcePhotos": [ "IMG_0306", "IMG_0324", "IMG_0327" ], "basis": "book" } ] **branches** [ { "condition": "Many questions or unresolved barrier", "action": "Arrange SC through reception.", "owner": "Doctor / receptionist", "timing": "Same visit", "nextState": "special consultation", "basis": "book", "sourcePhotos": [ "IMG_0296", "IMG_0297", "IMG_0300", "IMG_0305", "IMG_0306", "IMG_0320", "IMG_0321", "IMG_0322", "IMG_0324", "IMG_0327", "IMG_0330", "IMG_0331", "IMG_0332" ] }, { "condition": "Clinician finds no adjustment required", "action": "Use no-adjustment/no-charge handoff.", "owner": "Doctor", "timing": "Same visit", "nextState": "holding adjustment", "basis": "book", "sourcePhotos": [ "IMG_0296", "IMG_0297", "IMG_0300", "IMG_0305", "IMG_0306", "IMG_0320", "IMG_0321", "IMG_0322", "IMG_0324", "IMG_0327", "IMG_0330", "IMG_0331", "IMG_0332" ] } ] **completion** "Visit record and instructions complete; next appointment or documented care-choice closure exists." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-energy-check", "care-visit-exit", "care-greeting-exit-phrases", "care-rof-table-phrases", "care-pain-and-visit-steps", "care-focused-visit-handoff", "care-table-talk-efficiency", "care-treatment-explanations" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned every-visit preparation, explanation and next visit task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "arrived", "reviewed", "assessed", "instructions given", "next step confirmed" ] **gaps** [ "Source speed targets are not clinical service standards." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders." ### care-at-risk · Early disengagement detection and concern recovery Sources: IMG_0296, IMG_0305, IMG_0306, IMG_0320, IMG_0324, IMG_0325, IMG_0328 Trigger: Low energy, repeated questions, missed visits, poor response or stated desire to leave is observed Owner: Treating doctor; receptionist Purpose: Surface observed barriers before unaddressed concerns become dropout. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Notice and record the actual concern; ask what is going on rather than assume.", "owner": "Doctor", "timing": "At discovery", "sourcePhotos": [ "IMG_0296", "IMG_0328" ], "basis": "book" }, { "action": "Review attendance, ROF/orientation, re-exams, symptoms, adjustment comfort, goals and unresolved finance questions.", "owner": "Doctor", "timing": "Same visit or recall", "sourcePhotos": [ "IMG_0296", "IMG_0306", "IMG_0325" ], "basis": "book" }, { "action": "Listen and handle underlying issue; use SC if not understood or unresolved.", "owner": "Doctor", "timing": "Promptly", "sourcePhotos": [ "IMG_0296", "IMG_0320", "IMG_0328" ], "basis": "book" }, { "action": "Call departed patients to discover what went wrong and offer appropriate next step.", "owner": "Doctor", "timing": "As soon as possible", "sourcePhotos": [ "IMG_0296" ], "basis": "book" } ] **branches** [ { "condition": "Pain or poor response", "action": "Route to clinician assessment/peer help.", "owner": "Doctor", "timing": "At discovery", "nextState": "clinical review", "basis": "book", "sourcePhotos": [ "IMG_0296", "IMG_0305", "IMG_0306", "IMG_0320", "IMG_0324", "IMG_0325", "IMG_0328" ] }, { "condition": "Low engagement unexplained", "action": "Book SC; consider another doctor if relationship cannot be repaired.", "owner": "Doctor", "timing": "Promptly", "nextState": "special consultation", "basis": "book", "sourcePhotos": [ "IMG_0296", "IMG_0305", "IMG_0306", "IMG_0320", "IMG_0324", "IMG_0325", "IMG_0328" ] }, { "condition": "Patient chooses to leave", "action": "Respect choice, record departure and agreed future contact preference.", "owner": "Doctor / manager", "timing": "On decision", "nextState": "closed by choice", "basis": "inferred", "sourcePhotos": [ "IMG_0296", "IMG_0305", "IMG_0306", "IMG_0320", "IMG_0324", "IMG_0325", "IMG_0328" ] } ] **completion** "Specific barrier has an owner and disposition; patient-selected next step documented." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned early disengagement detection and concern recovery task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "signal noticed", "concern discovered", "action agreed", "resolved", "declined" ] **gaps** [ "No quantified risk score in book; proposed scoring must remain explainable and not substitute for conversation." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. Absence of referrals/family visits and seeking medical care are not clinical noncompliance or grounds to pressure patients." ### care-special-consult · Uninterrupted special consultation Sources: IMG_0298, IMG_0319, IMG_0320, IMG_0321, IMG_0322, IMG_0324, IMG_0327 Trigger: Patient has more questions than adjusting block permits, or a barrier remains unresolved Owner: Doctor and receptionist Purpose: Give complex questions and barriers time with the doctor. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Acknowledge questions and explicitly request reception book protected time.", "owner": "Doctor", "timing": "At concern", "sourcePhotos": [ "IMG_0298", "IMG_0327" ], "basis": "book" }, { "action": "Schedule non-adjusting consultation; source uses 10–15-minute slots.", "owner": "Receptionist", "timing": "Next suitable non-adjusting block", "sourcePhotos": [ "IMG_0319" ], "basis": "book" }, { "action": "Prepare pertinent films, goals and concern then listen, explain and agree next steps.", "owner": "Doctor", "timing": "Consultation", "sourcePhotos": [ "IMG_0320", "IMG_0321" ], "basis": "book" } ] **branches** [] **completion** "SC completed with concern answered or assigned onward and next care/calendar decision recorded." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-special-consult", "care-focused-visit-handoff" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned uninterrupted special consultation task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "requested", "scheduled", "prepared", "completed" ] **gaps** [ "No maximum wait/no-show sequence for SC in assigned pages." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders." ### care-returning-inactive · Returning inactive patient re-entry Sources: IMG_0297, IMG_0331 Trigger: Inactive patient returns Owner: Enrollment then doctor Purpose: Reassess what changed before resuming a previous treatment plan. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Welcome back without chastisement.", "owner": "Staff", "timing": "Arrival", "sourcePhotos": [ "IMG_0331" ], "basis": "book" }, { "action": "Pull films and conduct room-4 consultation for new accident, new injury and reason for return.", "owner": "Enrollment", "timing": "Before doctor", "sourcePhotos": [ "IMG_0297" ], "basis": "book" }, { "action": "Doctor reviews findings and explains relief/corrective options.", "owner": "Doctor", "timing": "Same visit", "sourcePhotos": [ "IMG_0297" ], "basis": "book" }, { "action": "Route patient-selected option to relief path or enrollment for finances/calendar.", "owner": "Doctor / enrollment", "timing": "Same visit", "sourcePhotos": [ "IMG_0297" ], "basis": "book" } ] **branches** [] **completion** "Updated reason/new-event history recorded and patient-selected next path assigned." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-returning-relief", "care-greeting-exit-phrases" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned returning inactive patient re-entry task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "returned", "new-event check", "doctor review", "relief", "corrective enrollment" ] **gaps** [ "Source does not define how old exam/imaging can be before new evaluation; clinician determines." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders." ### care-relief-path · Relief-care trial, reassessment and closure Sources: IMG_0297, IMG_0307, IMG_0308, IMG_0322 Trigger: Patient selects relief care, including returning or hesitant enrollment patient Owner: Doctor; receptionist; enrollment Purpose: Preserve the book’s relief choice with explicit symptom review and optional corrective transition. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Agree a clinician-appropriate brief relief plan; source example M/W/F three visits.", "owner": "Doctor / receptionist", "timing": "At choice", "sourcePhotos": [ "IMG_0297", "IMG_0307" ], "basis": "book" }, { "action": "Reassess symptoms at planned review; source Friday.", "owner": "Doctor", "timing": "After three visits in example", "sourcePhotos": [ "IMG_0297", "IMG_0307" ], "basis": "book" }, { "action": "If symptoms resolved ask whether patient wants return-on-recurrence or continued corrective care.", "owner": "Doctor", "timing": "At reassessment", "sourcePhotos": [ "IMG_0297", "IMG_0307" ], "basis": "book" }, { "action": "If relief only, stop further routine bookings and place future check-in on receptionist calendar.", "owner": "Receptionist", "timing": "At closure", "sourcePhotos": [ "IMG_0297", "IMG_0308" ], "basis": "book" }, { "action": "If corrective chosen, privately hand off to enrollment for finance and calendar.", "owner": "Enrollment", "timing": "At decision", "sourcePhotos": [ "IMG_0297", "IMG_0308" ], "basis": "book" } ] **branches** [ { "condition": "Still painful at Friday review", "action": "Source suggests two further days; clinician reassesses and sets appropriate plan.", "owner": "Doctor", "timing": "Friday example", "nextState": "relief continuing", "basis": "book", "sourcePhotos": [ "IMG_0297", "IMG_0307", "IMG_0308", "IMG_0322" ] }, { "condition": "Relief only and no routine visits wanted", "action": "Record closure and individually agreed check-in month.", "owner": "Receptionist", "timing": "At decision", "nextState": "relief completed", "basis": "book", "sourcePhotos": [ "IMG_0297", "IMG_0307", "IMG_0308", "IMG_0322" ] }, { "condition": "Corrective care selected", "action": "Create enrollment handoff.", "owner": "Doctor / enrollment", "timing": "At decision", "nextState": "corrective enrollment", "basis": "book", "sourcePhotos": [ "IMG_0297", "IMG_0307", "IMG_0308", "IMG_0322" ] } ] **completion** "Relief plan has review date; review ends in continued clinical plan, corrective enrollment or explicit no-more-bookings closure and optional agreed check-in." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-returning-relief", "care-relief-closure", "care-weekly-recommit" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned relief-care trial, reassessment and closure task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "relief selected", "trial active", "review due", "relief continuing", "relief complete", "corrective enrollment" ] **gaps** [ "Number of months to future check-in is blank; do not invent." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders." ### care-inactive-recall · Find stalled patients and call by lapse scenario Sources: IMG_0299 Trigger: Doctor has recall work time or an inactive/stalled patient is identified Owner: Doctor Purpose: Search all source queues rather than rely on a single generic inactive list. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Search noncompliant travel cards, reverse New Patient Log, Day2/Day3 stalled files, inactive cabinet files and date-based absence list.", "owner": "Doctor", "timing": "During recall time", "sourcePhotos": [ "IMG_0299" ], "basis": "book" }, { "action": "Classify missed ROF, several missed visits or long absence.", "owner": "Doctor", "timing": "Before call", "sourcePhotos": [ "IMG_0299" ], "basis": "book" }, { "action": "Use matching script and discover cause/concern.", "owner": "Doctor", "timing": "Recall call", "sourcePhotos": [ "IMG_0299" ], "basis": "book" }, { "action": "Offer appropriate findings review or no-charge evaluation and book chosen slot.", "owner": "Doctor / receptionist", "timing": "If accepted", "sourcePhotos": [ "IMG_0299" ], "basis": "book" } ] **branches** [ { "condition": "Missed ROF", "action": "Discuss missed findings-review appointment and offer morning/afternoon.", "owner": "Doctor", "timing": "Recall call", "nextState": "ROF rebooking", "basis": "book", "sourcePhotos": [ "IMG_0299" ] }, { "condition": "Several missed visits", "action": "Ask if everything is okay and resolve return barrier.", "owner": "Doctor", "timing": "Recall call", "nextState": "barrier review", "basis": "book", "sourcePhotos": [ "IMG_0299" ] }, { "condition": "Long absence", "action": "Ask original/new symptoms and use primary script with no-charge evaluation offer.", "owner": "Doctor", "timing": "Recall call", "nextState": "evaluation offer", "basis": "book", "sourcePhotos": [ "IMG_0299" ] } ] **completion** "Each searched patient has a supported contact outcome and booked appointment, explicit intentional closure or an open owned next action. No answer records an attempt only and leaves the recall objective pending; booked appointments are handed to reception." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-inactive-recall" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned find stalled patients and call by lapse scenario task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "identified", "classified", "call due", "contacted", "booked", "declined" ] **gaps** [ "No fixed age threshold, number of attempts, spacing or silent-no-answer closure in text." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders." ### care-technique-record · Technique baseline, response review and continuity Sources: IMG_0300, IMG_0323, IMG_0325, IMG_0327 Trigger: First adjustment or subsequent response review Owner: Treating doctor Purpose: Record what was actually done and preserve the effective combination across travel cards. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Review complaint, films and Dr. Use Form; choose clinical strategy.", "owner": "Doctor", "timing": "Before adjustment", "sourcePhotos": [ "IMG_0323", "IMG_0325", "IMG_0327" ], "basis": "book" }, { "action": "Record technique/procedures in travel-card comments at first adjustment.", "owner": "Doctor", "timing": "Immediately after first treatment", "sourcePhotos": [ "IMG_0300", "IMG_0325" ], "basis": "book" }, { "action": "At next visit compare symptoms/muscle/joint response and revise if necessary.", "owner": "Doctor", "timing": "Next visit", "sourcePhotos": [ "IMG_0300", "IMG_0325" ], "basis": "book" }, { "action": "Circle effective combination so subsequent cards and other doctors inherit it.", "owner": "Doctor", "timing": "When established", "sourcePhotos": [ "IMG_0300", "IMG_0325", "IMG_0327" ], "basis": "book" } ] **branches** [ { "condition": "Symptoms poorly tolerate approach", "action": "Modify technique as clinician determines.", "owner": "Doctor", "timing": "At review", "nextState": "revised approach", "basis": "book", "sourcePhotos": [ "IMG_0300", "IMG_0323", "IMG_0325", "IMG_0327" ] }, { "condition": "No improvement within 72 hours", "action": "Consult another doctor.", "owner": "Doctor", "timing": "72-hour source benchmark", "nextState": "peer review", "basis": "book", "sourcePhotos": [ "IMG_0300", "IMG_0323", "IMG_0325", "IMG_0327" ] } ] **completion** "Technique and response are recorded; effective notes transfer to new card with provenance." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-treatment-explanations" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned technique baseline, response review and continuity task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "baseline needed", "baseline recorded", "response reviewed", "effective combination", "peer review" ] **gaps** [ "No clinical diagnostic decision logic is supplied or appropriate to infer." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders." ### care-day-one · Day 1 examination and doctor fallback for enrollment Sources: IMG_0301, IMG_0302, IMG_0303, IMG_0329 Trigger: New patient arrives and completes initial intake Owner: Enrollment normally; doctor if unavailable Purpose: Complete consultation, assessment and explicit handoff to results review. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Introduce self, discuss prior chiropractic experiences and chief concern/impact.", "owner": "Enrollment or doctor", "timing": "Consultation", "sourcePhotos": [ "IMG_0301", "IMG_0303", "IMG_0329" ], "basis": "book" }, { "action": "Examine with clinician-selected tests and explain findings.", "owner": "Doctor", "timing": "After consultation", "sourcePhotos": [ "IMG_0301", "IMG_0302", "IMG_0303" ], "basis": "book" }, { "action": "Determine indicated films, explain fees and obtain applicable agreement.", "owner": "Doctor", "timing": "Before imaging", "sourcePhotos": [ "IMG_0302", "IMG_0303" ], "basis": "book" }, { "action": "Record exam/films/fees on travel card and prepare evening review.", "owner": "Doctor", "timing": "After assessment", "sourcePhotos": [ "IMG_0302" ], "basis": "book" }, { "action": "Explain ROF, support-person invitation and reception/payment handoff.", "owner": "Doctor / enrollment", "timing": "Before departure", "sourcePhotos": [ "IMG_0302", "IMG_0303" ], "basis": "book" } ] **branches** [ { "condition": "Enrollment unavailable", "action": "Doctor performs entire Day1 sequence.", "owner": "Doctor", "timing": "Arrival", "nextState": "doctor-led Day1", "basis": "book", "sourcePhotos": [ "IMG_0301", "IMG_0302", "IMG_0303", "IMG_0329" ] }, { "condition": "Not an appropriate case for chiropractic", "action": "Find someone who can help.", "owner": "Doctor", "timing": "Assessment", "nextState": "referred", "basis": "book", "sourcePhotos": [ "IMG_0301", "IMG_0302", "IMG_0303", "IMG_0329" ] } ] **completion** "Consult/exam/imaging decisions and fees recorded; ROF booked or reason no ROF documented." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-day-one-consult", "care-day-one-training", "care-new-patient-phrases", "care-exam-findings-explanation", "care-new-patient-thanks" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned day 1 examination and doctor fallback for enrollment task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "consultation", "exam", "imaging decision", "review prepared", "ROF handoff" ] **gaps** [ "No clinical red-flag/intake consent protocol is supplied in these pages." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders." ### care-rof-booking · Book ROF with attendance and support-person plan Sources: IMG_0302, IMG_0303 Trigger: Doctor finishes initial evaluation and plans report of findings Owner: Doctor or enrollment; receptionist Purpose: Close Day 1 with a specific prepared results-review appointment. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Explain evening review and next-day findings discussion.", "owner": "Doctor", "timing": "Day1 exit", "sourcePhotos": [ "IMG_0302", "IMG_0303" ], "basis": "book" }, { "action": "Invite spouse/significant other or chosen financial decision supporter.", "owner": "Doctor / enrollment", "timing": "At booking", "sourcePhotos": [ "IMG_0302", "IMG_0303" ], "basis": "book" }, { "action": "Book outside adjusting hours and fill ROF information paper.", "owner": "Receptionist / enrollment", "timing": "Before leaving", "sourcePhotos": [ "IMG_0302", "IMG_0303" ], "basis": "book" }, { "action": "Explain one-hour allowance, five-minute early arrival, group intro/private review and childcare fallback.", "owner": "Booking staff", "timing": "Booking close", "sourcePhotos": [ "IMG_0302", "IMG_0303" ], "basis": "book" } ] **branches** [ { "condition": "Support person cannot attend", "action": "Explore objection and arrange patient-authorized workable plan.", "owner": "Enrollment", "timing": "Before confirming", "nextState": "attendance plan", "basis": "book", "sourcePhotos": [ "IMG_0302", "IMG_0303" ] }, { "condition": "Babysitter falls through", "action": "Source says still attend and staff will assist; confirm actual staffing.", "owner": "Receptionist", "timing": "Before appointment", "nextState": "childcare exception", "basis": "book", "sourcePhotos": [ "IMG_0302", "IMG_0303" ] } ] **completion** "ROF slot, directions/instructions, support-person permission and practical attendance plan confirmed." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-day-one-rof" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned book rof with attendance and support-person plan task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "ROF needed", "support discussed", "scheduled", "instructions supplied" ] **gaps** [ "No exact reminder sequence in these pages; marketing daily page does require next-day reminder calls.", "Childcare plan depends on actual capacity." ] **clinicalBoundary** "Patient chooses support-person participation and information sharing; do not require third-party authorization of care." ### care-day-one-fees · Referral-source fee rules and Day 1 collection Sources: IMG_0303, IMG_0304 Trigger: Day 1 services planned or completed Owner: Doctor quotes; receptionist collects Purpose: Quote itemized costs and apply approved source-specific offer transparently. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Identify referral source and applicable approved offer; source distinguishes patient referral, family within/after two weeks, PGC/health fair.", "owner": "Enrollment / receptionist", "timing": "Before quote", "sourcePhotos": [ "IMG_0303" ], "basis": "book" }, { "action": "Explain indicated services and prices; source cash/insurance examples $30 exam/film and copay while verifying coverage.", "owner": "Doctor", "timing": "Before services", "sourcePhotos": [ "IMG_0303" ], "basis": "book" }, { "action": "State exam/film total, then discount/no-charge and payment choice; walk fee-due patient to reception.", "owner": "Receptionist", "timing": "Day1 checkout", "sourcePhotos": [ "IMG_0304" ], "basis": "book" } ] **branches** [ { "condition": "No fee owed", "action": "Release with ROF paper.", "owner": "Receptionist", "timing": "Checkout", "nextState": "paid/no charge", "basis": "book", "sourcePhotos": [ "IMG_0303", "IMG_0304" ] }, { "condition": "Insurance uncertain", "action": "Collect applicable approved copay and check coverage; do not guarantee payment.", "owner": "Billing / reception", "timing": "Day1", "nextState": "coverage verification", "basis": "book", "sourcePhotos": [ "IMG_0303", "IMG_0304" ] } ] **completion** "Patient received quote/discount explanation; payment or named exception recorded." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-day-one-training", "care-day-one-collection" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned referral-source fee rules and day 1 collection task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "source verified", "quoted", "discount applied", "collected", "billing exception" ] **gaps** [ "Historical prices are not present-day fees; payer/offer eligibility must be configured." ] **clinicalBoundary** "No automatic radiographs based on free offer or insurance reimbursement. Approved billing/fee rules required." ### care-weak-day-one · Doctor callback when Day 1 commitment is uncertain Sources: IMG_0304 Trigger: Doctor judges first visit weak or patient uncertain after leaving Owner: Doctor Purpose: Address remaining questions and confirm the planned ROF. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Review actual films/examination before callback.", "owner": "Doctor", "timing": "Later same day", "sourcePhotos": [ "IMG_0304" ], "basis": "book" }, { "action": "Call patient, explain accurate concern and confirm next-day time; invite questions.", "owner": "Doctor", "timing": "Later same day/night", "sourcePhotos": [ "IMG_0304" ], "basis": "book" }, { "action": "If patient authorized invited supporter participation, confirm shared appointment with them.", "owner": "Doctor", "timing": "During call", "sourcePhotos": [ "IMG_0304" ], "basis": "book" } ] **branches** [ { "condition": "Invited supporter answers and is aware", "action": "Confirm agreed ROF attendance without unauthorized disclosure.", "owner": "Doctor", "timing": "Call", "nextState": "ROF confirmed", "basis": "book", "sourcePhotos": [ "IMG_0304" ] }, { "condition": "Supporter unaware", "action": "Source gets patient and spouse together; obtain patient permission before any disclosure.", "owner": "Doctor", "timing": "Call", "nextState": "authorized joint discussion", "basis": "book", "sourcePhotos": [ "IMG_0304" ] } ] **completion** "The patient’s questions/attendance uncertainty are resolved with a recorded outcome, or an explicit patient choice supplies a final disposition. An unanswered attempt leaves the doctor-owned concern open for review; assigning a next step does not itself resolve it." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-weak-day-one" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned doctor callback when day 1 commitment is uncertain task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "uncertain", "reviewed", "call due", "contacted", "confirmed", "unresolved" ] **gaps** [ "No unanswered-call cadence supplied." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. No claim that findings are worse/correctable without actual clinical basis; no spouse disclosure without permission." ### care-mini-day-two · Bridge visit when ROF is several days away Sources: IMG_0305 Trigger: Initial ROF cannot occur for several days and clinician plans interim care Owner: Doctor Purpose: Avoid an unexplained gap while preserving required clinician review. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Place patient in consultation room with file, not films per source.", "owner": "Staff", "timing": "Bridge visit", "sourcePhotos": [ "IMG_0305" ], "basis": "book" }, { "action": "Explain clinician findings and intended small first adjustment/response check.", "owner": "Doctor", "timing": "Before care", "sourcePhotos": [ "IMG_0305" ], "basis": "book" }, { "action": "Proceed only with clinically appropriate assessment/consent and retain planned full ROF.", "owner": "Doctor", "timing": "Same visit", "sourcePhotos": [ "IMG_0305" ], "basis": "book" } ] **branches** [] **completion** "Interim clinical visit documented and full ROF remains booked." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-mini-day-two" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned bridge visit when rof is several days away task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "ROF delayed", "bridge planned", "interim visit", "ROF pending" ] **gaps** [ "“Several days” not quantified; no rule that every delay warrants treatment." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders." ### care-first-adjustment · First adjustment and observed-response loop Sources: IMG_0295, IMG_0305, IMG_0306, IMG_0308, IMG_0322 Trigger: Patient handed to doctor after ROF or mini Day2 Owner: Treating doctor Purpose: Explain first care, check response and create followup ownership. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Confirm enrollment handoff indicates program accepted or explicit short trial.", "owner": "Doctor / enrollment", "timing": "Before care", "sourcePhotos": [ "IMG_0308" ], "basis": "book" }, { "action": "Ask whether patient understands findings and explain each clinician-selected step.", "owner": "Doctor", "timing": "During first adjustment", "sourcePhotos": [ "IMG_0305" ], "basis": "book" }, { "action": "Teach side-roll/elbow rise and observe movement/response.", "owner": "Doctor", "timing": "After adjustment", "sourcePhotos": [ "IMG_0305" ], "basis": "book" }, { "action": "Ask how it feels if response unclear; document and route followup.", "owner": "Doctor", "timing": "Before exit", "sourcePhotos": [ "IMG_0306" ], "basis": "book" }, { "action": "Walk to reception or return to ROFer; ensure call-list addition.", "owner": "Doctor / reception", "timing": "Exit", "sourcePhotos": [ "IMG_0308", "IMG_0295" ], "basis": "book" } ] **branches** [ { "condition": "Improved", "action": "Acknowledge response and confirm next visit.", "owner": "Doctor", "timing": "At exit", "nextState": "followup planned", "basis": "book", "sourcePhotos": [ "IMG_0305", "IMG_0306", "IMG_0308", "IMG_0322" ] }, { "condition": "Worse", "action": "Assess and select response; source suggests different technique then next-day followup if still poor.", "owner": "Doctor", "timing": "Immediately", "nextState": "clinical review", "basis": "book", "sourcePhotos": [ "IMG_0305", "IMG_0306", "IMG_0308", "IMG_0322" ] }, { "condition": "Response unclear", "action": "Ask directly and assess.", "owner": "Doctor", "timing": "Immediately", "nextState": "response assessed", "basis": "book", "sourcePhotos": [ "IMG_0305", "IMG_0306", "IMG_0308", "IMG_0322" ] } ] **completion** "Response and clinician instructions documented; next appointment or clinical exception plus same-day doctor call assigned." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-first-adjustment", "care-first-adjustment-response", "care-first-response-expectations" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned first adjustment and observed-response loop task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "handoff received", "care explained", "response assessed", "followup assigned" ] **gaps** [ "Source one-minute target is not a limit on necessary care." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. Do not auto-deliver normal-detox explanation." ### care-trial-care · One-to-three-visit trial and early peer review Sources: IMG_0306, IMG_0308, IMG_0320, IMG_0325 Trigger: Enrollment explicitly hands off a patient accepting only 1–3 visits Owner: Doctor Purpose: Identify tentative enrollment and consciously review response and patient choice. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Flag short trial so doctor understands patient has not accepted full program.", "owner": "Enrollment", "timing": "Day2 handoff", "sourcePhotos": [ "IMG_0308" ], "basis": "book" }, { "action": "Explain each treatment and check symptom/experience response at every trial visit.", "owner": "Doctor", "timing": "First 1–3 visits", "sourcePhotos": [ "IMG_0306", "IMG_0308" ], "basis": "book" }, { "action": "Consult another doctor if noticeable improvement absent at 72 hours.", "owner": "Doctor", "timing": "Source 72-hour benchmark", "sourcePhotos": [ "IMG_0325" ], "basis": "book" }, { "action": "Re-evaluate after trial and return to enrollment only if patient chooses corrective program.", "owner": "Doctor / enrollment", "timing": "After three visits or agreed trial", "sourcePhotos": [ "IMG_0308" ], "basis": "book" } ] **branches** [ { "condition": "Poor response", "action": "Clinical reassessment/peer consultation; clinician chooses any technique/frequency changes.", "owner": "Doctor", "timing": "During trial", "nextState": "clinical review", "basis": "book", "sourcePhotos": [ "IMG_0306", "IMG_0308", "IMG_0320", "IMG_0325" ] }, { "condition": "Patient chooses relief only", "action": "Use relief-care closure and optional check-in.", "owner": "Doctor / reception", "timing": "Review", "nextState": "relief path", "basis": "book", "sourcePhotos": [ "IMG_0306", "IMG_0308", "IMG_0320", "IMG_0325" ] }, { "condition": "Patient elects correction", "action": "Hand off to finance/calendar enrollment.", "owner": "Doctor / enrollment", "timing": "Review", "nextState": "corrective enrollment", "basis": "book", "sourcePhotos": [ "IMG_0306", "IMG_0308", "IMG_0320", "IMG_0325" ] } ] **completion** "Trial concludes with recorded response and patient-selected next care state." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned one-to-three-visit trial and early peer review task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "trial scheduled", "trial active", "response concern", "peer review", "trial reviewed" ] **gaps** [ "72 hours is author aspiration/escalation, not guarantee." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders." ### care-adverse-response · Pain or concerning response after treatment Sources: IMG_0295, IMG_0297, IMG_0306, IMG_0326, IMG_0328 Trigger: Patient reports increased pain, headache, vomiting, injury, numbness or other concerning response Owner: Doctor Purpose: Ensure adverse-response complaints receive accountable clinician review and documented followup. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Capture exact report and contact doctor; preserve source objection prompt for context.", "owner": "Staff / doctor", "timing": "At report", "sourcePhotos": [ "IMG_0326", "IMG_0328" ], "basis": "book" }, { "action": "Doctor assesses complaint and chooses appropriate next action; source branches include technique change, close followup or another doctor.", "owner": "Doctor", "timing": "Promptly", "sourcePhotos": [ "IMG_0297", "IMG_0306", "IMG_0328" ], "basis": "book" }, { "action": "Set and document followup/clinical handoff; do not leave complaint as an unowned note.", "owner": "Doctor", "timing": "Before closure", "sourcePhotos": [ "IMG_0295", "IMG_0328" ], "basis": "book" } ] **branches** [ { "condition": "Patient says hurt and refuses return", "action": "Source offers another doctor/gentler approach and schedules appointment; patient choice and appropriate evaluation govern.", "owner": "Doctor", "timing": "During conversation", "nextState": "alternate clinician offered", "basis": "book", "sourcePhotos": [ "IMG_0295", "IMG_0297", "IMG_0306", "IMG_0326", "IMG_0328" ] }, { "condition": "Response not improving", "action": "Escalate to clinician/peer assessment rather than automatic repeat care.", "owner": "Doctor", "timing": "At review", "nextState": "clinical reassessment", "basis": "inferred", "sourcePhotos": [ "IMG_0295", "IMG_0297", "IMG_0306", "IMG_0326", "IMG_0328" ] } ] **completion** "A clinician has reviewed the report and documented disposition, followup and patient instructions." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-historical-adverse-objections", "care-complaint-calendar", "care-pain-and-visit-steps" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned pain or concerning response after treatment task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "reported", "clinician notified", "assessed", "instructions documented", "followup" ] **gaps** [ "Book does not supply an adequate symptom-specific urgency/triage protocol; licensed lead must author one before activation." ] **clinicalBoundary** "Source toxin, vomiting and blanket normal-response scripts must remain blocked from automated patient delivery. No automated diagnosis, reassurance or recommendation to ignore a concerning symptom." ### care-no-adjustment · Holding adjustment: no treatment and no charge Sources: IMG_0306, IMG_0323 Trigger: Doctor examines and decides an adjustment is not indicated Owner: Doctor and receptionist Purpose: Carry clinician decision through checkout without a mistaken adjustment charge. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Record assessment that adjustment is holding and no adjustment performed.", "owner": "Doctor", "timing": "Visit", "sourcePhotos": [ "IMG_0306", "IMG_0323" ], "basis": "book" }, { "action": "State agreed next visit, walk patient to desk and announce no charge.", "owner": "Doctor", "timing": "Checkout", "sourcePhotos": [ "IMG_0306", "IMG_0323" ], "basis": "book" }, { "action": "Reception acknowledges and confirms next appointment/no-charge disposition.", "owner": "Receptionist", "timing": "Checkout", "sourcePhotos": [ "IMG_0306", "IMG_0323" ], "basis": "book" } ] **branches** [] **completion** "Visit records no adjustment, no adjustment charge and clinician-set next visit." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-no-adjustment" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned holding adjustment: no treatment and no charge task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "assessed", "no adjustment", "reception handoff", "no charge confirmed" ] **gaps** [ "Source does not specify handling separately billable services; current billing policy must define." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders." ### care-enrollment-barrier · Unresolved Day 2 barrier escalates to doctor Sources: IMG_0307, IMG_0335 Trigger: Enrollment cannot resolve barrier or patient wants to think before care Owner: Enrollment then doctor Purpose: Prevent a finance/scheduling handoff from ending with an unexplored patient concern. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Tell patient doctor will check for other questions; get doctor after current adjustment.", "owner": "Enrollment", "timing": "Before patient leaves", "sourcePhotos": [ "IMG_0307" ], "basis": "book" }, { "action": "Privately confirm understanding and actual barrier.", "owner": "Doctor", "timing": "Same visit", "sourcePhotos": [ "IMG_0307" ], "basis": "book" }, { "action": "If resolved return to enrollment for finances/calendar.", "owner": "Doctor / enrollment", "timing": "Same visit", "sourcePhotos": [ "IMG_0307" ], "basis": "book" }, { "action": "If not resolved explain care options and let patient choose.", "owner": "Doctor", "timing": "Same visit", "sourcePhotos": [ "IMG_0307" ], "basis": "book" } ] **branches** [ { "condition": "Cost barrier", "action": "Explore whether affordable plan resolves concern; enrollment handles terms.", "owner": "Doctor / enrollment", "timing": "ROF", "nextState": "finance discussion", "basis": "book", "sourcePhotos": [ "IMG_0307", "IMG_0335" ] }, { "condition": "Schedule barrier", "action": "Explore feasible schedule rather than presume acceptance.", "owner": "Doctor / enrollment", "timing": "ROF", "nextState": "calendar discussion", "basis": "book", "sourcePhotos": [ "IMG_0307", "IMG_0335" ] }, { "condition": "Declines care", "action": "Record decision and only patient-agreed future contact.", "owner": "Enrollment", "timing": "At decision", "nextState": "declined", "basis": "inferred", "sourcePhotos": [ "IMG_0307", "IMG_0335" ] } ] **completion** "Barrier and patient decision documented; no open handoff without owner." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-barrier-rescue", "care-private-rof" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned unresolved day 2 barrier escalates to doctor task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "barrier identified", "doctor requested", "discussion", "enrolled", "relief selected", "declined" ] **gaps** [ "No exact post-decline followup interval supplied." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. Avoid coercion or pretending to audit another clinician; patient decision governs." ### care-distance-barrier · Travel-distance concern and schedule discussion Sources: IMG_0307 Trigger: Patient requests closer provider or says travel is too far Owner: Doctor then manager Purpose: Give travel barriers a named manager rather than lose them during checkout. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Acknowledge travel concern and determine practical need.", "owner": "Doctor", "timing": "At concern", "sourcePhotos": [ "IMG_0307" ], "basis": "book" }, { "action": "Offer manager discussion in room 4 about workable schedule.", "owner": "Manager", "timing": "Same visit", "sourcePhotos": [ "IMG_0307" ], "basis": "book" }, { "action": "Record agreed schedule or chosen transfer/referral.", "owner": "Manager / doctor", "timing": "Discussion completion", "sourcePhotos": [ "IMG_0307" ], "basis": "book" } ] **branches** [] **completion** "Feasible schedule or transfer decision recorded." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-distance-barrier" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned travel-distance concern and schedule discussion task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "distance concern", "manager discussion", "schedule adapted", "transfer" ] **gaps** [ "Source named referral locations/exclusivity may be obsolete." ] **clinicalBoundary** "Clinician recommends appropriate care/referral without unsupported exclusivity or pressure." ### care-departure · Patient departure and records request closure Sources: IMG_0307 Trigger: Patient requests films because leaving practice Owner: Doctor, enrollment or manager Purpose: Record concerns and arrange an auditable records release/stop to future visits. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Privately discover concern and offer to resolve it.", "owner": "Doctor / enrollment / manager", "timing": "At request", "sourcePhotos": [ "IMG_0307" ], "basis": "book" }, { "action": "If leaving, review requested records and obtain signed release/sign-out.", "owner": "Records owner", "timing": "At release", "sourcePhotos": [ "IMG_0307" ], "basis": "book" }, { "action": "Document patient file and computer; remove future appointments when departure confirmed; file inactive.", "owner": "Reception / records owner", "timing": "After decision", "sourcePhotos": [ "IMG_0307" ], "basis": "book" } ] **branches** [ { "condition": "Concern resolved and patient elects to continue", "action": "Return to agreed care/calendar.", "owner": "Doctor / enrollment", "timing": "Same conversation", "nextState": "active care", "basis": "book", "sourcePhotos": [ "IMG_0307" ] }, { "condition": "Leaving on negative terms", "action": "Source instructs erasing markings; do not activate this action. Preserve records and route to approved records policy.", "owner": "Records owner", "timing": "Before release", "nextState": "records review", "basis": "inferred", "sourcePhotos": [ "IMG_0307" ] } ] **completion** "Patient decision, records request/release, future calendar disposition and contact preference documented." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned patient departure and records request closure task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "departure requested", "concern discussed", "records prepared", "released", "closed" ] **gaps** [ "No records retention, copy/access or preservation policy specified." ] **clinicalBoundary** "Visually verified source erasure instruction is archival only; never silently destroy or alter clinical records. Privacy/records lead must approve release procedure." ### care-re-exam · Every-12-visit or concern-triggered re-exam Sources: IMG_0309, IMG_0310 Trigger: Visit count reaches each 12-visit grey line or clinician identifies slipping commitment Owner: Doctor or appropriately authorized CA; reception prepares Purpose: Link milestone to progress report, clinician review and completed handoff. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Flag milestone and pull films before shift.", "owner": "Receptionist", "timing": "Before due visit", "sourcePhotos": [ "IMG_0309" ], "basis": "book" }, { "action": "For first re-exam collect Initial Progress Report before adjustment and attach to travel card.", "owner": "Receptionist", "timing": "Check-in", "sourcePhotos": [ "IMG_0309" ], "basis": "book" }, { "action": "After adjustment take patient and films to exam area; doctor covers if enrollment unavailable.", "owner": "Examiner", "timing": "Same visit", "sourcePhotos": [ "IMG_0309" ], "basis": "book" }, { "action": "Review all report issues, repeat positive tests, ask four questions, review rehab/heel lift, adherence and barriers.", "owner": "Examiner", "timing": "Before visit ends", "sourcePhotos": [ "IMG_0309", "IMG_0310" ], "basis": "book" }, { "action": "If improving invite referrals/testimonial; document exam #2 and circled RE; return card to front.", "owner": "Examiner / receptionist", "timing": "Visit completion", "sourcePhotos": [ "IMG_0309", "IMG_0310" ], "basis": "book" } ] **branches** [ { "condition": "Progress/commitment concern", "action": "Address barrier and clinician recommendations before closing.", "owner": "Doctor / enrollment", "timing": "Same visit", "nextState": "concern plan", "basis": "book", "sourcePhotos": [ "IMG_0309", "IMG_0310" ] }, { "condition": "Enrollment unavailable", "action": "Doctor conducts re-exam.", "owner": "Doctor", "timing": "Due visit", "nextState": "doctor re-exam", "basis": "book", "sourcePhotos": [ "IMG_0309", "IMG_0310" ] } ] **completion** "Progress report reviewed, clinical reassessment documented, questions/barriers dispositioned and correct exam mark recorded." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-re-exam-questions", "care-re-exam-practice" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned every-12-visit or concern-triggered re-exam task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "due", "prepared", "report collected", "re-exam performed", "followthrough complete" ] **gaps** [ "Book labels first RE with exam #2; preserve nomenclature rather than silently renumber." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. Software prompts due review, never automatically orders imaging or demands commitment score 10." ### care-comparison-imaging · Comparison-image review milestone Sources: IMG_0309, IMG_0310, IMG_0312, IMG_0322 Trigger: Clinician reviews 24–36-visit/2–3-month milestone or needs more information Owner: Doctor Purpose: Ensure followup imaging, when ordered, results in a prepared re-report. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Review whether imaging is indicated and which views are needed; source usually selected comparison views.", "owner": "Doctor", "timing": "Milestone review", "sourcePhotos": [ "IMG_0309", "IMG_0310", "IMG_0312" ], "basis": "book" }, { "action": "Document ordered views on travel card, mark exam and circle RE3.", "owner": "Doctor", "timing": "Before imaging", "sourcePhotos": [ "IMG_0309" ], "basis": "book" }, { "action": "Acquire approved views and place in original folder for comparison.", "owner": "Imaging staff", "timing": "Ordered session", "sourcePhotos": [ "IMG_0312" ], "basis": "book" }, { "action": "Walk patient to reception and request RR booking.", "owner": "Staff / receptionist", "timing": "After imaging", "sourcePhotos": [ "IMG_0309" ], "basis": "book" } ] **branches** [ { "condition": "No clinical indication", "action": "Record clinician decision; do not generate automatic imaging order.", "owner": "Doctor", "timing": "Review", "nextState": "review completed", "basis": "inferred", "sourcePhotos": [ "IMG_0309", "IMG_0310", "IMG_0312", "IMG_0322" ] }, { "condition": "Monthly maintenance patient", "action": "Source says every 12 visits/year; clinician reviews appropriateness.", "owner": "Doctor", "timing": "12-visit milestone", "nextState": "clinical imaging decision", "basis": "book", "sourcePhotos": [ "IMG_0309", "IMG_0310", "IMG_0312", "IMG_0322" ] } ] **completion** "Documented imaging decision, completed ordered study if any and booked results discussion." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned comparison-image review milestone task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "review due", "clinician decision", "ordered", "images ready", "RR booked" ] **gaps** [ "Source conflicts: 24–36 visits vs before 35th visit/card end; approval needed.", "2–3 months and annual maintenance are source timings, not automatic standards." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders." ### care-re-report · Comparison-film report with unfavorable-result escalation Sources: IMG_0307, IMG_0310, IMG_0311, IMG_0312 Trigger: Comparison films ready and RR requested Owner: Doctor; enrollment for clinician-approved favorable report Purpose: Prepare correct film comparisons and route difficult results to doctor time. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Mark and compare films before appointment; check positioning/markings.", "owner": "Doctor", "timing": "Before RR", "sourcePhotos": [ "IMG_0310", "IMG_0311", "IMG_0312" ], "basis": "book" }, { "action": "If uncertain about interpretation/explanation obtain knowledgeable clarification before appointment.", "owner": "Doctor / enrollment / manager", "timing": "Before RR", "sourcePhotos": [ "IMG_0307", "IMG_0312" ], "basis": "book" }, { "action": "For favorable change clinician or enrollment presents comparison, asks patient observations and confirms clinician-set schedule.", "owner": "Doctor / enrollment", "timing": "RR during adjusting hours", "sourcePhotos": [ "IMG_0307", "IMG_0310" ], "basis": "book" }, { "action": "For unfavorable change doctor conducts report outside adjusting hours.", "owner": "Doctor / receptionist", "timing": "Reschedule before RR", "sourcePhotos": [ "IMG_0307" ], "basis": "book" } ] **branches** [ { "condition": "Marking or positioning incorrect", "action": "Correct markings or clinically justify repeat image; RR next visit.", "owner": "Doctor", "timing": "Before report", "nextState": "technical correction", "basis": "book", "sourcePhotos": [ "IMG_0307", "IMG_0310", "IMG_0311", "IMG_0312" ] }, { "condition": "Technically correct but worse", "action": "Doctor evaluates cause and explains; do not automatically assign blame or normal deterioration.", "owner": "Doctor", "timing": "Protected report time", "nextState": "clinical review", "basis": "book", "sourcePhotos": [ "IMG_0307", "IMG_0310", "IMG_0311", "IMG_0312" ] }, { "condition": "Improved", "action": "Document progress and new schedule, discuss continued care and voluntary referrals.", "owner": "Doctor / enrollment", "timing": "RR", "nextState": "plan updated", "basis": "book", "sourcePhotos": [ "IMG_0307", "IMG_0310", "IMG_0311", "IMG_0312" ] } ] **completion** "Validated comparison, clinician-reviewed explanation, patient discussion and next plan recorded." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-re-report-improved", "care-re-report-worse" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned comparison-film report with unfavorable-result escalation task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "comparison pending", "technical check", "clarification needed", "ready", "doctor review", "reported" ] **gaps** [ "No validated method for source percentage-improvement calculation is specified." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders." ### care-film-marking · Daily film marking and Dr. Use Form handoff Sources: IMG_0292, IMG_0312, IMG_0319, IMG_0327 Trigger: New or comparison films acquired Owner: Doctor Purpose: No acquired film stays invisible in an unassigned stack. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Place films in NEW PATIENTS–TO BE MARKED work queue / corresponding re-exam queue.", "owner": "Imaging staff", "timing": "After processing", "sourcePhotos": [ "IMG_0312" ], "basis": "book" }, { "action": "Review and mark appropriate clinical findings, including abnormalities/pathology; complete Dr. Use Form.", "owner": "Doctor", "timing": "Throughout day, complete before leaving", "sourcePhotos": [ "IMG_0312", "IMG_0319" ], "basis": "book" }, { "action": "Ensure key information transfers to travel card and Dr. Use Form reaches Billing.", "owner": "Doctor / staff", "timing": "Before leaving", "sourcePhotos": [ "IMG_0319", "IMG_0327" ], "basis": "book" }, { "action": "Seek senior clarification if findings/changes cannot be explained.", "owner": "Doctor", "timing": "Before scheduled review", "sourcePhotos": [ "IMG_0312" ], "basis": "book" } ] **branches** [] **completion** "Films reviewed/marked, interpretation and form complete, next visit materials ready." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned daily film marking and dr. use form handoff task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "to be marked", "reviewing", "clarification", "complete", "handoff" ] **gaps** [ "Historical physical slot names need equivalent digital queues; imaging interpretation workflow requires current clinical policy." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders." ### care-imaging-training · Radiography terminology and six-view competency Sources: IMG_0293, IMG_0313, IMG_0314 Trigger: Doctor or qualified imaging staff assigned radiography training Owner: Qualified trainer; trainee Purpose: Retain the equipment/reference material within role training. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Learn views, anatomy and analog equipment definitions.", "owner": "Trainee", "timing": "Training", "sourcePhotos": [ "IMG_0313" ], "basis": "book" }, { "action": "Learn six basic view setups and safety/labeling sequence.", "owner": "Trainee / trainer", "timing": "Supervised training", "sourcePhotos": [ "IMG_0314" ], "basis": "book" }, { "action": "Demonstrate taking, processing and marking films plus form completion as applicable.", "owner": "Trainer", "timing": "Competency assessment", "sourcePhotos": [ "IMG_0293" ], "basis": "book" } ] **branches** [] **completion** "Current equipment-specific competency signed off; source glossary remains searchable." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned radiography terminology and six-view competency task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "assigned", "reference reviewed", "supervised practice", "signed off" ] **gaps** [ "Book does not specify imaging licensure/certification rules or digital-equipment equivalent." ] **clinicalBoundary** "Training content does not authorize unlicensed radiation use. Historical equipment procedure must be replaced by approved current operator protocol." ### care-imaging-acquisition · Clinician-ordered image acquisition checklist Sources: IMG_0314, IMG_0317 Trigger: Doctor orders indicated radiographs Owner: Qualified imaging operator; doctor Purpose: Attach patient checks, acquisition record and next handoff to each ordered study. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Screen pregnancy possibility and obtain doctor review when positive/uncertain; remove metal/shoes and prepare patient.", "owner": "Qualified operator", "timing": "Before exposure", "sourcePhotos": [ "IMG_0314", "IMG_0317" ], "basis": "book" }, { "action": "Use approved equipment-specific measurements, positioning and exposure procedure.", "owner": "Qualified operator", "timing": "Acquisition", "sourcePhotos": [ "IMG_0314", "IMG_0317" ], "basis": "book" }, { "action": "Label and separate films by patient and mark views performed on travel card.", "owner": "Operator", "timing": "Immediately", "sourcePhotos": [ "IMG_0317" ], "basis": "book" }, { "action": "New patient dresses and waits for doctor; established patient taken to CA1 to book RR.", "owner": "Operator / CA1", "timing": "After acquisition", "sourcePhotos": [ "IMG_0317" ], "basis": "book" } ] **branches** [ { "condition": "Pregnancy possibility", "action": "Get doctor; no automatic exception clearance.", "owner": "Operator / doctor", "timing": "Before exposure", "nextState": "clinical review", "basis": "book", "sourcePhotos": [ "IMG_0314", "IMG_0317" ] }, { "condition": "New patient", "action": "Return to initial doctor handoff.", "owner": "Operator", "timing": "After study", "nextState": "Day1 doctor", "basis": "book", "sourcePhotos": [ "IMG_0314", "IMG_0317" ] }, { "condition": "Existing patient", "action": "Schedule RR.", "owner": "CA1", "timing": "After study", "nextState": "RR scheduling", "basis": "book", "sourcePhotos": [ "IMG_0314", "IMG_0317" ] } ] **completion** "Study identity/views documented and correct patient followup assigned." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned clinician-ordered image acquisition checklist task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "ordered", "screening", "ready", "acquired", "labeled", "handed off" ] **gaps** [ "Source menstrual timing/negative-test clearance not sufficient as modern safety protocol." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. Radiation-safety and pregnancy decisions require current approved clinical policy; never automatically order/expose." ### care-film-filing · Patient and episode-specific film filing Sources: IMG_0317 Trigger: New or existing patient films processed Owner: Imaging/records staff Purpose: Avoid misfiling multiple regular, auto and work-comp image envelopes. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "New patient: label new envelope surname first and date, place NP shelf.", "owner": "Imaging staff", "timing": "After processing", "sourcePhotos": [ "IMG_0317" ], "basis": "book" }, { "action": "Existing patient: use original appropriate episode folder and RE shelf.", "owner": "Imaging staff", "timing": "After processing", "sourcePhotos": [ "IMG_0317" ], "basis": "book" }, { "action": "Check Regular/Auto/Work Comp episode and alphabetic placement.", "owner": "Records staff", "timing": "Before filing", "sourcePhotos": [ "IMG_0317" ], "basis": "book" } ] **branches** [] **completion** "Images linked to correct person/episode/date and review queue." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned patient and episode-specific film filing task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "processed", "identity checked", "episode checked", "filed" ] **gaps** [ "Digital record identifier and duplicate-person reconciliation not specified." ] **clinicalBoundary** "Protect clinical records and maintain patient/episode identity." ### care-film-processing · Analog film processor daily operation Sources: IMG_0315 Trigger: Analog film processing workday or batch begins Owner: Trained operator Purpose: Retain conditional equipment process if analog equipment actually exists. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "DAY switch at arrival, allow source 20-minute warmup; subsequent warmup 5–10 minutes.", "owner": "Operator", "timing": "Opening", "sourcePhotos": [ "IMG_0315" ], "basis": "book" }, { "action": "Close door/lights off, correctly tag film and flash using source equipment method.", "owner": "Operator", "timing": "Each film", "sourcePhotos": [ "IMG_0315" ], "basis": "book" }, { "action": "Feed film, reload cassette, wait beep before next film.", "owner": "Operator", "timing": "Processing", "sourcePhotos": [ "IMG_0315" ], "basis": "book" }, { "action": "NIGHT switch before leaving.", "owner": "Operator", "timing": "Closing", "sourcePhotos": [ "IMG_0315" ], "basis": "book" } ] **branches** [] **completion** "Films processed/labeled, cassettes reloaded and processor closed down." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned analog film processor daily operation task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "warming", "ready", "processing", "closed" ] **gaps** [ "Analog machine model and continued use unknown; digital imaging may retire this flow as archival." ] **clinicalBoundary** "Manufacturer instructions and qualified operator supersede historical machine-specific procedure." ### care-processor-maintenance · Analog processor maintenance and chemistry exceptions Sources: IMG_0315, IMG_0316 Trigger: Monthly service due, low chemical level, wet film or equipment fault Owner: Trained operator; source escalation Dr. Thomas Purpose: Track monthly service and resolve contradictory chemical thresholds before activation. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Drain and clean monthly under trained instruction.", "owner": "Operator", "timing": "Monthly", "sourcePhotos": [ "IMG_0315" ], "basis": "book" }, { "action": "Monitor chemical tanks and replenish using approved current recipe.", "owner": "Operator", "timing": "When low", "sourcePhotos": [ "IMG_0315", "IMG_0316" ], "basis": "book" }, { "action": "Source recipe at two gallons adds A, water, B then water to seven gallons; preserve as equipment-specific reference.", "owner": "Operator", "timing": "Approved replenishment only", "sourcePhotos": [ "IMG_0316" ], "basis": "book" }, { "action": "Protect films and close boxes before light/fault investigation.", "owner": "Operator", "timing": "Fault", "sourcePhotos": [ "IMG_0315" ], "basis": "book" } ] **branches** [ { "condition": "Films emerge wet", "action": "Source calls for fixer change; trained lead diagnoses.", "owner": "Operator", "timing": "At fault", "nextState": "maintenance", "basis": "book", "sourcePhotos": [ "IMG_0315", "IMG_0316" ] }, { "condition": "Tank too low draws air", "action": "Call Dr. Thomas / current qualified equipment lead.", "owner": "Operator", "timing": "At fault", "nextState": "escalated", "basis": "book", "sourcePhotos": [ "IMG_0315", "IMG_0316" ] }, { "condition": "Refill threshold unclear", "action": "Resolve one-versus-two-gallon source conflict against manufacturer before use.", "owner": "Equipment lead", "timing": "Before activation", "nextState": "policy decision", "basis": "inferred", "sourcePhotos": [ "IMG_0315", "IMG_0316" ] } ] **completion** "Service/level/fault records complete with qualified signoff and safe operating status." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned analog processor maintenance and chemistry exceptions task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "service due", "inspected", "maintenance", "fault", "cleared" ] **gaps** [ "One gallon in IMG_0315 vs two gallons in IMG_0316, confirmed visually.", "Chemical brand/PPE/disposal/manufacturer instructions not supplied." ] **clinicalBoundary** "No automated chemical mixing or hazardous repair instructions from this archival recipe; approved equipment protocol required." ### care-rehab-adherence · Prescribed rehabilitation instruction and check-ins Sources: IMG_0293, IMG_0309, IMG_0318, IMG_0323 Trigger: Clinician prescribes rehabilitation or reviews adherence Owner: Doctor / trained rehab specialist Purpose: Connect prescribed exercises to patient understanding and later progress review. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Clinician selects exercise, equipment and individualized parameters; source covers head weights, wall traction, wobble, wedges and shoulder weights.", "owner": "Doctor", "timing": "At prescription", "sourcePhotos": [ "IMG_0318", "IMG_0323" ], "basis": "book" }, { "action": "Demonstrate and confirm technique/equipment use.", "owner": "Rehab specialist", "timing": "Instruction visit", "sourcePhotos": [ "IMG_0293", "IMG_0318" ], "basis": "book" }, { "action": "Record home plan; source example after adjustment and morning/night 10–15 minutes, 5–7 days/week.", "owner": "Doctor / rehab specialist", "timing": "Plan agreement", "sourcePhotos": [ "IMG_0318" ], "basis": "book" }, { "action": "Review adherence/heel lift and barriers at re-exam.", "owner": "Examiner", "timing": "12-visit re-exam", "sourcePhotos": [ "IMG_0309" ], "basis": "book" } ] **branches** [] **completion** "Clinician-approved home plan delivered, patient understanding recorded and adherence reviewed." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "Offer an optional patient link containing only clinician-approved instructions and acknowledgement; generate rehab review tasks at source re-exams.", "basis": "inferred", "rationale": "Preserves book teaching/adherence duty without automating prescription." } ] **states** [ "prescribed", "taught", "home plan", "review due", "reviewed" ] **gaps** [ "No exercise-specific contraindication or symptom escalation rules supplied." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. Do not auto-prescribe weights/reps from historical sex-based starting examples." ### care-weekly-rhythm · Daily education and Monday/Wednesday/Friday patient focus Sources: IMG_0292, IMG_0322, IMG_0330 Trigger: Treatment day opens or visit reaches weekly focus Owner: Doctor Purpose: Preserve the author’s recurring conversation rhythm without losing individualized care. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Prepare one piece of relevant education and weekly handout.", "owner": "Doctor", "timing": "Daily / weekly", "sourcePhotos": [ "IMG_0292", "IMG_0322" ], "basis": "book" }, { "action": "Monday focus on appropriate voluntary referrals and record asks.", "owner": "Doctor", "timing": "Monday", "sourcePhotos": [ "IMG_0292", "IMG_0322" ], "basis": "book" }, { "action": "Wednesday identify re-exams needed for progress/concerns.", "owner": "Doctor", "timing": "Wednesday", "sourcePhotos": [ "IMG_0292", "IMG_0322" ], "basis": "book" }, { "action": "Friday confirm next week’s clinically appropriate plan and feasible patient commitment.", "owner": "Doctor", "timing": "Friday", "sourcePhotos": [ "IMG_0292", "IMG_0322" ], "basis": "book" } ] **branches** [] **completion** "Daily education and applicable weekday followthrough recorded, with next-week schedule addressed." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-weekly-recommit", "care-rof-table-phrases" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned daily education and monday/wednesday/friday patient focus task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "daily focus ready", "visit conversation", "followthrough recorded" ] **gaps** [ "Source four-referral-card Monday cue and five-asks daily are separate metrics; no single conversion rule." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders." ### care-quality-capture · Daytime issue capture and end-of-day quality close Sources: IMG_0292, IMG_0320, IMG_0322, IMG_0326 Trigger: Staff/doctor notices referral, concern, testimonial, card defect or forgotten patient Owner: Doctor Purpose: Replace the pocket 3x5 with a durable owned queue. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Capture patient-linked or operational issue when noticed.", "owner": "Doctor", "timing": "Throughout day", "sourcePhotos": [ "IMG_0320", "IMG_0322", "IMG_0326" ], "basis": "book" }, { "action": "Track specific referral asks; source five paperclips move pockets and count at day end.", "owner": "Doctor", "timing": "Each referral ask", "sourcePhotos": [ "IMG_0322" ], "basis": "book" }, { "action": "Handle captured items before going home; place completed card in Quality Control.", "owner": "Doctor", "timing": "End of day", "sourcePhotos": [ "IMG_0322", "IMG_0326" ], "basis": "book" }, { "action": "Summarize week and send Division5; prepare next-week plan Friday.", "owner": "Doctor", "timing": "Week end", "sourcePhotos": [ "IMG_0292" ], "basis": "book" } ] **branches** [] **completion** "Every captured item has outcome or explicitly retained owner/next action; daily referral count and weekly summary filed." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create mobile quick-capture action list with patient context, source/script link, due time and explicit completion evidence.", "basis": "inferred", "rationale": "Digitizes 3x5 and prevents remembered tasks from disappearing." }, { "action": "Show unclosed items in end-of-day and next huddle; require named owner/next due time for carryover.", "basis": "inferred", "rationale": "Modernizes the book’s before-going-home closure rule." } ] **states** [ "captured", "assigned", "handled", "carried with owner", "quality filed" ] **gaps** [ "Source does not define overdue backup routing; proposed ownership escalation should be configured." ] **clinicalBoundary** "" ### care-issue-routing · Attendance, finance, insurance, PIP and pain issue ownership Sources: IMG_0326 Trigger: A visit reveals attendance, finances, insurance, PIP-limit or improvement problem Owner: Doctor identifies; enrollment/billing/doctor resolves Purpose: Assign each patient barrier to someone able to resolve it the same day. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Record exact concern at discovery.", "owner": "Doctor", "timing": "During visit", "sourcePhotos": [ "IMG_0326" ], "basis": "book" }, { "action": "For financial issue bring enrollment and patient to private room.", "owner": "Doctor / enrollment", "timing": "Same visit", "sourcePhotos": [ "IMG_0326" ], "basis": "book" }, { "action": "Route insurance/PIP concern to appropriate billing review and pain concern to doctor.", "owner": "Doctor / billing", "timing": "Same day", "sourcePhotos": [ "IMG_0326" ], "basis": "book" }, { "action": "Review captured issues and handle before leaving.", "owner": "Doctor", "timing": "End of day", "sourcePhotos": [ "IMG_0326" ], "basis": "book" } ] **branches** [ { "condition": "Missed visits", "action": "Discuss and connect to attendance/recommit flow.", "owner": "Doctor / receptionist", "timing": "At discovery", "nextState": "attendance plan", "basis": "book", "sourcePhotos": [ "IMG_0326" ] }, { "condition": "Insurance problem or PIP nearly exhausted", "action": "Assign billing case review with required action.", "owner": "Billing + doctor", "timing": "At discovery", "nextState": "billing review", "basis": "book", "sourcePhotos": [ "IMG_0326" ] }, { "condition": "Pain not improving", "action": "Clinical assessment/peer review.", "owner": "Doctor", "timing": "At discovery", "nextState": "clinical review", "basis": "book", "sourcePhotos": [ "IMG_0326" ] } ] **completion** "Issue-specific owner has documented resolution or clear next action." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned attendance, finance, insurance, pip and pain issue ownership task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "noticed", "classified", "handed off", "resolved", "continuing" ] **gaps** [ "The source says fix it but does not specify PIP thresholds, insurer deadlines or detailed resolution templates." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders." ### care-billing-complaint · Alleged billing dishonesty private resolution Sources: IMG_0328 Trigger: Patient states billing is dishonest or incorrect Owner: Doctor, manager or appropriate billing staff Purpose: Give trust-threatening billing complaints a direct manager handoff. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Take patient to private room and ask what they mean.", "owner": "Doctor", "timing": "Immediately", "sourcePhotos": [ "IMG_0328" ], "basis": "book" }, { "action": "Find relevant manager/staff and summarize concern in front of patient for a shared understanding.", "owner": "Doctor", "timing": "Same conversation", "sourcePhotos": [ "IMG_0328" ], "basis": "book" }, { "action": "Explicitly ask staff to handle; document ownership and patient followthrough.", "owner": "Manager / billing", "timing": "Before patient leaves", "sourcePhotos": [ "IMG_0328" ], "basis": "book" } ] **branches** [] **completion** "Complaint has owner, findings and patient-communicated resolution or next promised contact." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-complaint-calendar" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned alleged billing dishonesty private resolution task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "raised", "private clarification", "manager handoff", "under review", "resolved" ] **gaps** [ "No response-time promise, refund authority or formal complaint procedure supplied." ] **clinicalBoundary** "Do not make continued clinical care conditional on abandoning a billing complaint; share only appropriate account details." ### care-calendar-change · Temporary or ongoing reduction in attendance Sources: IMG_0328, IMG_0331, IMG_0332 Trigger: Patient asks to reduce schedule or begins changing it independently Owner: Receptionist then doctor or manager Purpose: Differentiate a one-week exception from an ongoing change that needs clinical discussion. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Ask whether change is only this week or ongoing.", "owner": "Receptionist", "timing": "At request", "sourcePhotos": [ "IMG_0328" ], "basis": "book" }, { "action": "If temporary agree this-week calendar and book make-up day next week.", "owner": "Receptionist", "timing": "Same conversation", "sourcePhotos": [ "IMG_0328" ], "basis": "book" }, { "action": "If ongoing get doctor, or manager if doctor unavailable, for private discussion.", "owner": "Receptionist / doctor / manager", "timing": "Same visit", "sourcePhotos": [ "IMG_0328" ], "basis": "book" }, { "action": "Explore what patient can manage, clinician explains plan, record feasible agreed schedule.", "owner": "Doctor", "timing": "Private review", "sourcePhotos": [ "IMG_0328", "IMG_0332" ], "basis": "book" } ] **branches** [ { "condition": "Temporary this week", "action": "Update exception and agreed make-up day.", "owner": "Receptionist", "timing": "At request", "nextState": "temporary exception", "basis": "book", "sourcePhotos": [ "IMG_0328", "IMG_0332" ] }, { "condition": "Permanent reduction", "action": "Doctor/manager consultation.", "owner": "Doctor / manager", "timing": "Promptly", "nextState": "calendar review", "basis": "book", "sourcePhotos": [ "IMG_0328", "IMG_0332" ] }, { "condition": "Self-directed schedule already changed", "action": "Special consultation; review goals and accept feasible commitment.", "owner": "Doctor", "timing": "At discovery", "nextState": "revised plan", "basis": "book", "sourcePhotos": [ "IMG_0328", "IMG_0332" ] } ] **completion** "Clinician and patient agreed calendar/exception recorded; next appointment reflects decision." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-complaint-calendar", "care-objection-phrase-bank" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned temporary or ongoing reduction in attendance task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "change requested", "temporary", "clinical discussion", "agreement recorded" ] **gaps** [ "No maximum makeup window beyond next-week example; do not create care debt automatically." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders." ### care-orientation-rof · Group orientation, private findings and enrollment decision Sources: IMG_0329, IMG_0330, IMG_0334, IMG_0335 Trigger: Patient attends scheduled report of findings Owner: Doctor with financial/enrollment staff Purpose: Preserve structured education then private personalized discussion and finance handoff. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Welcome group, explain example films then private review and voluntary affordability choice; silence phones.", "owner": "Doctor", "timing": "Opening", "sourcePhotos": [ "IMG_0334" ], "basis": "book" }, { "action": "Deliver clinician-approved education with visual examples; archived source contains nine body topics.", "owner": "Doctor", "timing": "Group portion", "sourcePhotos": [ "IMG_0334" ], "basis": "book" }, { "action": "Close, then take first-arrived couple privately with films and financial staff.", "owner": "Doctor / finance staff", "timing": "After group", "sourcePhotos": [ "IMG_0335" ], "basis": "book" }, { "action": "Ask observation, meaning, consequences and commitment; discuss approved individualized care schedule.", "owner": "Doctor", "timing": "Private report", "sourcePhotos": [ "IMG_0335" ], "basis": "book" }, { "action": "If patient wants plan, hand to finance/enrollment then adjustment; if concerns route barrier discussion.", "owner": "Doctor / enrollment", "timing": "Decision", "sourcePhotos": [ "IMG_0335" ], "basis": "book" } ] **branches** [ { "condition": "Cost concern", "action": "Explore affordability and other remaining barriers.", "owner": "Enrollment", "timing": "Private report", "nextState": "finance options", "basis": "book", "sourcePhotos": [ "IMG_0329", "IMG_0330", "IMG_0334", "IMG_0335" ] }, { "condition": "Scheduling concern", "action": "Explore feasible schedule and other barriers.", "owner": "Doctor / enrollment", "timing": "Private report", "nextState": "calendar options", "basis": "book", "sourcePhotos": [ "IMG_0329", "IMG_0330", "IMG_0334", "IMG_0335" ] }, { "condition": "Patient chooses no care", "action": "Record choice and authorized followup preference.", "owner": "Enrollment", "timing": "Decision", "nextState": "declined", "basis": "inferred", "sourcePhotos": [ "IMG_0329", "IMG_0330", "IMG_0334", "IMG_0335" ] } ] **completion** "Private findings reviewed, clinical choice/consent recorded and finance/calendar or decline path completed." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-orientation-report", "care-private-rof", "care-new-patient-phrases" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned group orientation, private findings and enrollment decision task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "arrived", "group introduction", "private findings", "options discussed", "enrollment", "declined" ] **gaps** [ "Historical statistics/story are not verified; content approval required.", "Book does not supply modern informed-consent or documented financial agreement." ] **clinicalBoundary** "Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. No auto-delivery of anti-medical rhetoric, pressure tactics, historical statistical claims or child-treatment expectations." ### care-billing-review · Weekly doctor and billing case review Sources: IMG_0292, IMG_0336 Trigger: Weekly doctor-billing meeting or billing request Owner: Doctor and Billing manager Purpose: Resolve missing reports and insurer documentation before bills stall. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Handle ad hoc billing requests during non-adjusting hours.", "owner": "Doctor", "timing": "As requested", "sourcePhotos": [ "IMG_0336" ], "basis": "book" }, { "action": "Meet at fixed weekly time, usually Tuesday; review all auto/work-comp accounts and needed actions.", "owner": "Doctor + billing", "timing": "Weekly Tuesday example", "sourcePhotos": [ "IMG_0292", "IMG_0336" ], "basis": "book" }, { "action": "Review travel cards for insurers and initial/prognosis/final letters; discuss progress and case next action.", "owner": "Doctor + billing", "timing": "Meeting", "sourcePhotos": [ "IMG_0336" ], "basis": "book" }, { "action": "Complete/sign all reports and give billing needed documentation.", "owner": "Doctor", "timing": "Meeting followthrough", "sourcePhotos": [ "IMG_0292", "IMG_0336" ], "basis": "book" } ] **branches** [] **completion** "Each reviewed case has signed required documentation or named next action; billing confirms receipt." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned weekly doctor and billing case review task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "case queued", "review due", "reviewed", "reports pending", "billing ready" ] **gaps** [ "Payer-specific rules and report deadlines not supplied." ] **clinicalBoundary** "Clinical reports reflect actual findings; billing eligibility and payer requirements require current approval." ### care-visit-documentation · Same-visit chart completion for auto/work-comp Sources: IMG_0292, IMG_0336 Trigger: Auto-accident/work-comp adjustment completed Owner: Doctor Purpose: Ensure each billed encounter has complete clinical documentation. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Complete chart notes/travel-card comments before patient leaves when possible.", "owner": "Doctor", "timing": "At visit", "sourcePhotos": [ "IMG_0336" ], "basis": "book" }, { "action": "Mark SOAP, services and travel card.", "owner": "Doctor", "timing": "During adjusting hours", "sourcePhotos": [ "IMG_0292" ], "basis": "book" }, { "action": "Billing includes completed notes with each auto/work-comp bill.", "owner": "Billing specialist", "timing": "Each bill", "sourcePhotos": [ "IMG_0336" ], "basis": "book" } ] **branches** [] **completion** "Signed/complete clinical note and performed services linked to bill-ready encounter." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned same-visit chart completion for auto/work-comp task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "seen", "note pending", "documented", "billing ready" ] **gaps** [ "Source does not define a complete modern note schema, signature or amendment policy." ] **clinicalBoundary** "No fabricated or auto-signed clinical documentation." ### care-referral-capture · Patient referral name-to-doctor-call handoff Sources: IMG_0333, IMG_0345 Trigger: Improving patient, companion or staff conversation produces a potential referral Owner: Doctor / rehab specialist / all staff; receptionist captures Purpose: Carry an invited referral from conversation to assigned followup. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Ask improving patient who else has concern and whether help can be offered.", "owner": "Doctor / staff", "timing": "Appropriate conversation", "sourcePhotos": [ "IMG_0333", "IMG_0345" ], "basis": "book" }, { "action": "Collect name/number and source/context; rehab specialist can use referral/group lead paper.", "owner": "Staff / receptionist", "timing": "At interest", "sourcePhotos": [ "IMG_0345" ], "basis": "book" }, { "action": "Ask referrer to tell friend doctor plans to call in next day or two; walk to reception with context.", "owner": "Doctor", "timing": "Same visit", "sourcePhotos": [ "IMG_0333" ], "basis": "book" }, { "action": "Assign doctor referral call and record outcome/booking.", "owner": "Doctor", "timing": "Next day or two per source commitment", "sourcePhotos": [ "IMG_0333" ], "basis": "book" } ] **branches** [ { "condition": "Instead yields group/business opportunity", "action": "Route to community-outreach lead with contact details.", "owner": "Receptionist / marketing", "timing": "At capture", "nextState": "event lead", "basis": "book", "sourcePhotos": [ "IMG_0333", "IMG_0345" ] }, { "condition": "Permission to contact unclear", "action": "Verify permission before outbound contact.", "owner": "Marketing", "timing": "Before call", "nextState": "permission pending", "basis": "inferred", "sourcePhotos": [ "IMG_0333", "IMG_0345" ] } ] **completion** "Referral has contact permission/status, assigned call outcome and appointment or explicit closure." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-referral-capture" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned patient referral name-to-doctor-call handoff task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "referral offered", "permission check", "doctor call due", "contacted", "booked", "closed" ] **gaps** [ "Source has name/address versus name/phone variation; collect verified contact method.", "No unresponsive-referral retry cadence." ] **clinicalBoundary** "Do not disclose existing patient information or assume the friend consented; honor contact preferences." ### care-family-check · New-patient family invitation and two-week review Sources: IMG_0303, IMG_0325, IMG_0345 Trigger: New patient starts care Owner: Doctor, staff and enrollment Purpose: Track offered family evaluation without dropping a missed invitation. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Offer family check at practice expense during first two weeks.", "owner": "Doctor / staff", "timing": "Within first two weeks", "sourcePhotos": [ "IMG_0345" ], "basis": "book" }, { "action": "Record family interest and approved offer terms; source pricing within two weeks differs after.", "owner": "Enrollment", "timing": "At invitation", "sourcePhotos": [ "IMG_0303" ], "basis": "book" }, { "action": "If family did not come during two weeks, offer later rather than abandon.", "owner": "Staff", "timing": "After window missed", "sourcePhotos": [ "IMG_0345" ], "basis": "book" } ] **branches** [] **completion** "Invitation/outcome and any accepted appointment recorded; no implied obligation to bring family." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned new-patient family invitation and two-week review task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "eligible invitation", "offered", "interested", "booked", "declined", "later followup" ] **gaps** [ "Family pricing conflict: IMG0325 says family free including films broadly; IMG0303 distinguishes after-two-week exam only. Requires one approved offer." ] **clinicalBoundary** "Family care is voluntary; clinical need and guardian consent govern evaluation/imaging, never a quota or condition of current patient care." ### care-community-outreach · Business alliances, lectures and charity opportunities Sources: IMG_0321, IMG_0333, IMG_0340, IMG_0345 Trigger: Business/group/charity contact or enthusiastic patient offers connection Owner: Marketing and doctor Purpose: Give every staff-discovered speaking or alliance lead a concrete event path. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Collect organization, decision contact and opportunity from patient/group/business conversations.", "owner": "All staff / marketing", "timing": "At lead", "sourcePhotos": [ "IMG_0333", "IMG_0345" ], "basis": "book" }, { "action": "Call HR for short doctor meeting or arrange group lecture.", "owner": "Marketing", "timing": "Outreach", "sourcePhotos": [ "IMG_0345" ], "basis": "book" }, { "action": "Determine truthful offer, donation or talk and record event details/calendar.", "owner": "Doctor / marketing", "timing": "Before agreement", "sourcePhotos": [ "IMG_0345" ], "basis": "book" }, { "action": "Doctor attends/teaches; lead collection flows to marketing followup.", "owner": "Doctor / marketing", "timing": "Event", "sourcePhotos": [ "IMG_0321", "IMG_0345" ], "basis": "book" } ] **branches** [ { "condition": "Donation introduction", "action": "Arrange five-minute doctor meeting, with accurate description of offer.", "owner": "Marketing", "timing": "Scheduling", "nextState": "meeting booked", "basis": "book", "sourcePhotos": [ "IMG_0321", "IMG_0333", "IMG_0340", "IMG_0345" ] }, { "condition": "Charity partnership", "action": "Agree actual charity need and event contribution terms.", "owner": "Marketing / doctor", "timing": "Planning", "nextState": "charity event", "basis": "book", "sourcePhotos": [ "IMG_0321", "IMG_0333", "IMG_0340", "IMG_0345" ] }, { "condition": "Patient is strong advocate", "action": "Ask work/groups/enrichment leader contact.", "owner": "Doctor", "timing": "Visit conversation", "nextState": "speaker lead", "basis": "book", "sourcePhotos": [ "IMG_0321", "IMG_0333", "IMG_0340", "IMG_0345" ] } ] **completion** "Opportunity has scheduled/declined outcome, contact, truthful offer and post-event lead owner." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-referral-capture", "care-donation-meeting" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned business alliances, lectures and charity opportunities task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "lead", "contacting", "meeting", "event planned", "event complete", "followup" ] **gaps** [ "Source nonprofit membership and donation-hour claims are clinic-specific and unverified." ] **clinicalBoundary** "Contact permissions, truthful offers and clinical-content approval are required before outreach." ### care-marketing-day · Marketing daily checklist and weekly signed close Sources: IMG_0337 Trigger: Marketing workday begins Owner: Marketing staff Purpose: Make preparation, booking quality, recalled misses and daily reporting visible. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Check mailbox and post daily goals/targets.", "owner": "Marketing", "timing": "Start of day", "sourcePhotos": [ "IMG_0337" ], "basis": "book" }, { "action": "Use primary script; book approved appointment blocks and give correct directions.", "owner": "Marketing", "timing": "Each booking", "sourcePhotos": [ "IMG_0337" ], "basis": "book" }, { "action": "Ensure event contact/address/time/company and supplies ready.", "owner": "Marketing", "timing": "Before event", "sourcePhotos": [ "IMG_0337" ], "basis": "book" }, { "action": "Recall missed scheduled prospects and call next-day reminders.", "owner": "Marketing", "timing": "During day / before leaving", "sourcePhotos": [ "IMG_0337" ], "basis": "book" }, { "action": "Organize call sheets, record monthly stats, check mailbox and goal result.", "owner": "Marketing", "timing": "Before leaving", "sourcePhotos": [ "IMG_0337" ], "basis": "book" }, { "action": "Write next-week goals/battle plan, sign and place in Division7.", "owner": "Marketing", "timing": "Week end", "sourcePhotos": [ "IMG_0337" ], "basis": "book" } ] **branches** [] **completion** "Daily checklist and weekly plan are recorded. Every missed-appointment/reminder attempt has an accurate outcome; unresolved patient objectives remain open with an owner and next action even when the daily checklist is closed." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned marketing daily checklist and weekly signed close task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "prepared", "calling", "events", "reconciling", "closed" ] **gaps** [ "Current schedule and role responsible for overlap with reception need configuration." ] **clinicalBoundary** "" ### care-marketing-events · Event calendar, readiness and recurring marketing events Sources: IMG_0337, IMG_0340, IMG_0345 Trigger: Marketing event booked or recurring event planning due Owner: Marketing staff and doctor Purpose: Prevent booked opportunities from missing logistics or followup ownership. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Record company, contact name/phone, full address and event time on calendar.", "owner": "Marketing", "timing": "At booking", "sourcePhotos": [ "IMG_0337" ], "basis": "book" }, { "action": "Prepare pens, stress surveys, candy, table coverings, massage boxes and business cards.", "owner": "Marketing", "timing": "Before event", "sourcePhotos": [ "IMG_0337" ], "basis": "book" }, { "action": "Run event and capture leads for appropriate marketing call queue.", "owner": "Marketing / doctor", "timing": "Event", "sourcePhotos": [ "IMG_0345" ], "basis": "book" }, { "action": "Plan appreciation days every two months and doctor health talk monthly per hierarchy.", "owner": "Marketing / doctor", "timing": "Recurring planning", "sourcePhotos": [ "IMG_0340" ], "basis": "book" } ] **branches** [ { "condition": "Patient appreciation day", "action": "Choose theme and approved voluntary referral-prize mechanics.", "owner": "Marketing", "timing": "Planning", "nextState": "appreciation event", "basis": "book", "sourcePhotos": [ "IMG_0337", "IMG_0340", "IMG_0345" ] }, { "condition": "Staff referral competition", "action": "Optional source proposal; record approved rules if used.", "owner": "Manager", "timing": "Planning", "nextState": "staff campaign", "basis": "book", "sourcePhotos": [ "IMG_0337", "IMG_0340", "IMG_0345" ] } ] **completion** "Event complete/cancelled with lead disposition and stats; no unassigned post-event leads." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned event calendar, readiness and recurring marketing events task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "planned", "scheduled", "supplies ready", "delivered", "followup assigned" ] **gaps** [ "Source bi-monthly ambiguity on345 resolved provisionally by explicit every-two-months on340; obtain final approval.", "No lead followup timing specified in assigned pages." ] **clinicalBoundary** "" ### care-marketing-reminder · Next-day prospect appointment reminder call Sources: IMG_0337 Trigger: Prospect appointment is scheduled for next day Owner: Marketing staff Purpose: Preserve explicit end-of-day reminder calling. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Review tomorrow’s scheduled appointments.", "owner": "Marketing", "timing": "Before leaving", "sourcePhotos": [ "IMG_0337" ], "basis": "book" }, { "action": "Call reminders and record contact/outcome.", "owner": "Marketing", "timing": "Before leaving prior workday", "sourcePhotos": [ "IMG_0337" ], "basis": "book" }, { "action": "Hand scheduling changes to receptionist and preserve new appointment.", "owner": "Marketing / receptionist", "timing": "When requested", "sourcePhotos": [ "IMG_0337" ], "basis": "book" } ] **branches** [] **completion** "The reminder contact outcome and any appointment change are recorded. A no-answer call may complete the attempt subtask, but it does not mark the patient reached or the appointment confirmed; unresolved confirmation remains visibly owned until a later response, appointment event or reviewed disposition. The source gives no repeat-attempt cadence." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "Generate next-day reminder-call tasks with appointment/directions; optional consented SMS confirmation supplements call.", "basis": "inferred", "rationale": "Modernizes book reminder requirement without dropping voice contact." } ] **states** [ "due", "call attempted", "confirmed", "reschedule requested", "updated" ] **gaps** [ "No exact wording or unreachable-patient repeat cadence on this page." ] **clinicalBoundary** "" ### care-marketing-recall · Recall missed marketing appointments Sources: IMG_0337 Trigger: A scheduled marketing prospect appointment is marked missed Owner: Marketing staff Purpose: Ensure every missed appointment created by marketing receives a recall attempt. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Identify all scheduled appointments that missed.", "owner": "Marketing", "timing": "Daily", "sourcePhotos": [ "IMG_0337" ], "basis": "book" }, { "action": "Call missed prospect and record reason/outcome.", "owner": "Marketing", "timing": "Daily recall", "sourcePhotos": [ "IMG_0337" ], "basis": "book" }, { "action": "Route accepted new time to booking, unresolved barrier to appropriate owner.", "owner": "Marketing / receptionist", "timing": "After conversation", "sourcePhotos": [ "IMG_0337" ], "basis": "book" } ] **branches** [] **completion** "Each missed prospect has a new appointment or documented intentional closure. An unanswered call or unresolved barrier remains an open owned recovery task with a next action/review; recording an attempt is not resolution." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned recall missed marketing appointments task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "missed", "recall due", "attempted", "contacted", "rebooked", "closed" ] **gaps** [ "Page requires recall but gives no retry schedule, timing within day or exact script. Cross-reference reception missed-appointment rules." ] **clinicalBoundary** "" ### care-pgc-partner · Business gift-card distribution and unredeemed followup Sources: IMG_0338 Trigger: Business partner accepts gift-card alliance or distributes card Owner: Marketing staff; partner Purpose: Track partner gift recipient from distribution through redemption appointment. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Send partner followup letter confirming agreed actual benefit and no-cost-to-partner terms.", "owner": "Marketing", "timing": "After meeting", "sourcePhotos": [ "IMG_0338" ], "basis": "book" }, { "action": "Partner hands card to eligible customer with redemption explanation.", "owner": "Partner", "timing": "At offer trigger", "sourcePhotos": [ "IMG_0338" ], "basis": "book" }, { "action": "Obtain permitted recipient name/phone and distribution record.", "owner": "Partner / marketing", "timing": "At distribution", "sourcePhotos": [ "IMG_0338" ], "basis": "book" }, { "action": "If not self-redeemed within agreed interval, call with partner/gift context and offer time.", "owner": "Marketing", "timing": "Configured reasonable timeframe", "sourcePhotos": [ "IMG_0338" ], "basis": "book" } ] **branches** [ { "condition": "Recipient already booked/redeemed", "action": "Suppress redundant redemption chase.", "owner": "Marketing", "timing": "Before call", "nextState": "redeemed", "basis": "inferred", "sourcePhotos": [ "IMG_0338" ] }, { "condition": "No permission to contact", "action": "Keep contact pending until appropriate permission established.", "owner": "Marketing", "timing": "Before call", "nextState": "permission pending", "basis": "inferred", "sourcePhotos": [ "IMG_0338" ] } ] **completion** "The distributed gift is redeemed/booked, declined or otherwise intentionally closed with documented reason. An unredeemed gift in an owned followup state remains pending; an attempted call alone does not complete the redemption objective." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-pgc-partner-letter" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned business gift-card distribution and unredeemed followup task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "partner agreed", "gift distributed", "permission verified", "redemption pending", "called", "booked", "redeemed" ] **gaps** [ "“Reasonable time frame” undefined; do not invent number.", "Benefit content and program names are historical." ] **clinicalBoundary** "No misleading gift/health claims; approved offers and contact permissions needed." ### care-marketing-hierarchy · Priority-ordered marketing queues and work blocks Sources: IMG_0340, IMG_0341, IMG_0345 Trigger: Marketing plans day or selects next outreach work Owner: Marketing staff Purpose: Keep highest-priority inbound/warm sources visible before lower-priority campaigns. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Prioritize referral, massage and stress-survey calls, then alliances, health fairs, PGCs, social, appreciation, talks, charity, newsletter/email and website.", "owner": "Marketing", "timing": "Daily planning", "sourcePhotos": [ "IMG_0340" ], "basis": "book" }, { "action": "Use suitable source contact windows for HR, field promotion and home calls after adapting approved current schedule.", "owner": "Marketing", "timing": "Planning", "sourcePhotos": [ "IMG_0341" ], "basis": "book" }, { "action": "Ask other staff to contribute referral/group leads.", "owner": "Marketing / all staff", "timing": "Ongoing", "sourcePhotos": [ "IMG_0345" ], "basis": "book" } ] **branches** [] **completion** "Prioritized work queues and chosen time blocks are documented with activity counts." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned priority-ordered marketing queues and work blocks task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "priorities set", "blocks planned", "working queue", "reviewed" ] **gaps** [ "Source offers conflicting best-call-time examples rather than one mandatory window.", "No detailed social, website or newsletter sequence on these pages." ] **clinicalBoundary** "" ### care-marketing-stats · Daily marketing metrics and weekly goal review Sources: IMG_0337, IMG_0340, IMG_0341, IMG_0342, IMG_0343, IMG_0346 Trigger: Marketing activity occurs or day/week closes Owner: Marketing staff; manager Purpose: Measure arrivals completing Day1 and leading activity, not just appointments. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Tally calls and record bookings, events, arrivals, alliances, surveys/leads and PGC distribution/activation.", "owner": "Marketing", "timing": "Daily", "sourcePhotos": [ "IMG_0337", "IMG_0343" ], "basis": "book" }, { "action": "Count NPI only for qualified arrival who completes Day1.", "owner": "Marketing", "timing": "At Day1 completion", "sourcePhotos": [ "IMG_0341" ], "basis": "book" }, { "action": "Graph future/completed events, calls, NPI booked this/next week, leads and PGCs; display 12 weeks stats and four months calendars.", "owner": "Marketing", "timing": "Update during week", "sourcePhotos": [ "IMG_0341", "IMG_0342" ], "basis": "book" }, { "action": "Compare source weekly targets:150+ lead calls,80+ event calls,10+ drop-ins/3 on-spot schedules,4–5 events,80–100 leads.", "owner": "Marketing / manager", "timing": "Weekly", "sourcePhotos": [ "IMG_0340", "IMG_0341" ], "basis": "book" }, { "action": "Write next-week goals/battle plan, sign and submit to Div7; ask for help if efforts not improving.", "owner": "Marketing", "timing": "Week end", "sourcePhotos": [ "IMG_0337", "IMG_0346" ], "basis": "book" } ] **branches** [] **completion** "Daily records reconcile to source events and weekly review produces dated goals/actions." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned daily marketing metrics and weekly goal review task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "activity logged", "daily reconciled", "weekly compared", "plan signed" ] **gaps** [ "Targets are historical examples to approve for present staffing.", "Toolbox/Sub-products sheet and following stat sheet need cross-part references." ] **clinicalBoundary** "" ### care-marketing-training · Marketing setup, practice and measurable signoff Sources: IMG_0341, IMG_0342, IMG_0343, IMG_0344 Trigger: Marketing staff hired or department established Owner: Marketing trainee and trainer Purpose: Prepare equipment/materials and certify skills with observed results. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Provide computer/workspace, phone/headset, materials and displayed operating sheets/calendars.", "owner": "Manager", "timing": "Setup", "sourcePhotos": [ "IMG_0341", "IMG_0342" ], "basis": "book" }, { "action": "Complete marketing course, obtain Sub-products sheet, attend Monday forms meeting and planned Joshua support calls.", "owner": "Trainee / trainer", "timing": "Training", "sourcePhotos": [ "IMG_0342" ], "basis": "book" }, { "action": "Learn approved explanation and primary script, lead collection and activity tracking.", "owner": "Trainee", "timing": "Training", "sourcePhotos": [ "IMG_0343", "IMG_0344" ], "basis": "book" }, { "action": "Trainer signs/dates explanation skill, five NPI arrivals using script, sufficient names/numbers, tracking competence and ten NPI/week capability.", "owner": "Trainer", "timing": "Observed competency", "sourcePhotos": [ "IMG_0343" ], "basis": "book" } ] **branches** [] **completion** "Resources ready and each competency demonstrated/signed with evidence." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [ "care-marketing-explanation" ] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned marketing setup, practice and measurable signoff task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "setup", "learning", "practice", "evidence", "signed off" ] **gaps** [ "Bi-weekly support-call meaning and present trainer need configuration.", "Source 70% conversation conversion benchmark and10 NPI/week not guarantees." ] **clinicalBoundary** "Marketing may explain approved services but cannot diagnose or repeat unsupported disease/cure claims." ### care-lead-qualification · Historical marketing qualification with human exception review Sources: IMG_0341, IMG_0343 Trigger: A prospect enters marketing queue Owner: Marketing staff; enrollment for financial barriers Purpose: Keep author’s lead definition transparent without converting it into denial of care. **preconditions** [ "Applicable person/event identified; responsible role assigned." ] **steps** [ { "action": "Record source marketing criteria: local home/work, full-time employment,23+ and a health concern they want addressed.", "owner": "Marketing", "timing": "Lead intake", "sourcePhotos": [ "IMG_0343" ], "basis": "book" }, { "action": "If source criteria not met, review whether parent accompaniment or enrollment financial solution applies.", "owner": "Enrollment", "timing": "Qualification discussion", "sourcePhotos": [ "IMG_0343" ], "basis": "book" }, { "action": "Distinguish qualified marketing lead from arrived/completed-Day1 NPI metric.", "owner": "Marketing", "timing": "Reporting", "sourcePhotos": [ "IMG_0341" ], "basis": "book" } ] **branches** [ { "condition": "Financial barrier or younger prospect", "action": "Human enrollment review; do not automatically deny appointment or care.", "owner": "Enrollment", "timing": "Intake", "nextState": "exception review", "basis": "inferred", "sourcePhotos": [ "IMG_0341", "IMG_0343" ] } ] **completion** "Marketing classification and any exception documented separately from clinical access decision." **stopConditions** [ "Proposed: workflow completion evidence recorded.", "Proposed: no-longer-applicable/duplicate event closed with reason; patient-contact tasks stop on declined contact or opt-out." ] **escalation** [ "Proposed: overdue or unacknowledged handoff remains visible to the responsible role and manager; escalation interval must be configured, as the book does not supply one here." ] **scriptIds** [] **proposedAutomation** [ { "action": "On the stated trigger, create an assigned historical marketing qualification with human exception review task with source and applicable script links, source timing, required outcome and next owner.", "basis": "inferred", "rationale": "Digitizes the book duty while retaining human ownership and a verifiable completion state." }, { "action": "Prevent silent closure: require completion evidence or explicit reason/next action, and surface overdue items in the daily review.", "basis": "inferred", "rationale": "Makes the source handoff accountable without inventing patient-care decisions or new contact cadence." } ] **states** [ "intake", "marketing criteria reviewed", "exception review", "appointment eligible" ] **gaps** [ "Age23/employment assumptions require present-day business/policy review." ] **clinicalBoundary** "Marketing segmentation is not medical eligibility. Do not auto-exclude by age or employment or infer ability to pay from protected traits." ### grow-prospect-discovery · Primary Script qualification and evaluation invitation Sources: IMG_0348, IMG_0349, IMG_0366 Trigger: Conversation with prospect or a source workflow invokes Primary Script Owner: Marketing CA / trained team member Purpose: Turn an expressed health concern into a consented evaluation appointment, or gracefully close/referral-route. **preconditions** [] **steps** [ { "action": "Ask health concern; if none ask desired changes in energy, weight or sleep.", "owner": "Marketing CA / trained team member", "timing": "At conversation start", "basis": "book", "sourcePhotos": [ "IMG_0348", "IMG_0349", "IMG_0366" ] }, { "action": "Ask permission and identify highest-priority concern; explore duration, attempted solutions/results, severity and effects on work/family/hobbies.", "owner": "Marketing CA / trained team member", "timing": "Before offer", "basis": "book", "sourcePhotos": [ "IMG_0348", "IMG_0349", "IMG_0366" ] }, { "action": "Ask permission to explain chiropractic; use reviewed version of source analogy, offer no-cost evaluation and morning/afternoon scheduling.", "owner": "Marketing CA / trained team member", "timing": "After concern exploration", "basis": "book", "sourcePhotos": [ "IMG_0348", "IMG_0349", "IMG_0366" ] } ] **branches** [ { "condition": "No concern and no desired change", "action": "Say not qualified for this offer; briefly explain and ask whether someone else could use gift.", "owner": "Marketing CA / trained team member", "timing": "Same conversation", "nextState": "Referral offered or closed", "basis": "book", "sourcePhotos": [ "IMG_0348", "IMG_0349", "IMG_0366" ] }, { "condition": "Referral offered", "action": "Collect name/phone and reported concern; create separate referral record under approved contact policy.", "owner": "Marketing CA / trained team member", "timing": "Same conversation", "nextState": "Referral pending contact", "basis": "book", "sourcePhotos": [ "IMG_0348", "IMG_0349", "IMG_0366" ] }, { "condition": "No concern and no referral", "action": "Thank and end; do not beg or add incentives.", "owner": "Marketing CA / trained team member", "timing": "Immediately", "nextState": "Closed—no need", "basis": "book", "sourcePhotos": [ "IMG_0348", "IMG_0349", "IMG_0366" ] } ] **completion** "Appointment booked, referral routed, or no-need closure recorded." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-primary", "grow-primary-alt" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "New conversation", "Concern identified", "Evaluation offered", "Booked", "Referral pending contact", "Closed—no need" ] **gaps** [ "No retry count, response time or later nurture sequence defined here." ] **clinicalBoundary** "Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation." ### grow-survey-lead · Stress-survey lead follow-up Sources: IMG_0350, IMG_0353, IMG_0364, IMG_0365 Trigger: Stress survey collected at screening/fair Owner: Marketing / trained caller Purpose: Ensure each survey lead has an owner, conversation outcome and appointment or explicit closure. **preconditions** [] **steps** [ { "action": "Record name, phone, event source and stated concerns.", "owner": "Marketing / trained caller", "timing": "After event", "basis": "book", "sourcePhotos": [ "IMG_0350", "IMG_0353", "IMG_0364", "IMG_0365" ] }, { "action": "Call, name event and refer to listed symptoms; ask most concerning symptom and run Primary Script.", "owner": "Marketing / trained caller", "timing": "Source says later; interval unspecified", "basis": "book", "sourcePhotos": [ "IMG_0350", "IMG_0353", "IMG_0364", "IMG_0365" ] }, { "action": "Book evaluation for interested prospect.", "owner": "Marketing / trained caller", "timing": "During call", "basis": "book", "sourcePhotos": [ "IMG_0350", "IMG_0353", "IMG_0364", "IMG_0365" ] } ] **branches** [ { "condition": "No symptoms/desire to change", "action": "Thank prospect and end.", "owner": "Marketing / trained caller", "timing": "During call", "nextState": "Closed—no need", "basis": "book", "sourcePhotos": [ "IMG_0350", "IMG_0353", "IMG_0364", "IMG_0365" ] }, { "condition": "Unable to reach", "action": "Record attempt and retain assigned follow-up task; policy must set attempts/timing.", "owner": "Marketing", "timing": "After attempt", "nextState": "Awaiting contact", "basis": "inferred", "sourcePhotos": [ "IMG_0350", "IMG_0353", "IMG_0364", "IMG_0365" ] } ] **completion** "All collected surveys have booked/closed/owned-next-action outcome." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-survey-call", "grow-primary" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." }, { "action": "Optional SMS companion after consent, linking booking/directions while preserving phone task.", "basis": "inferred", "rationale": "User requested modern touchpoints; source prescribes telephone follow-up, not SMS." } ] **states** [ "Captured", "Assigned", "Called", "Booked", "Closed", "Awaiting contact" ] **gaps** [ "No initial call interval, unsuccessful-attempt cadence or final deadline specified." ] **clinicalBoundary** "Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation. Referral contact supplied by someone else is not recipient consent. Proposed contact eligibility and refusal/suppression controls require approved policy; do not expose patient health details publicly. Advertised scarcity and value must be factual." ### grow-pgc-handout · Public gift certificate distribution and attribution Sources: IMG_0351, IMG_0356 Trigger: Outreach encounter or gift distribution Owner: Marketing CA Purpose: Track distributed gift cards, issuer attribution and promised follow-up. **preconditions** [] **steps** [ { "action": "Take PGCs and contact cards; identify local prospects.", "owner": "Marketing CA", "timing": "Before/outreach", "basis": "book", "sourcePhotos": [ "IMG_0351", "IMG_0356" ] }, { "action": "Offer card; if accepted initial it, return it activated and explain booking number.", "owner": "Marketing CA", "timing": "At handout", "basis": "book", "sourcePhotos": [ "IMG_0351", "IMG_0356" ] }, { "action": "Capture first name and phone and explain call in a couple days if not booked.", "owner": "Marketing CA", "timing": "At acceptance", "basis": "book", "sourcePhotos": [ "IMG_0351", "IMG_0356" ] }, { "action": "Route accepted unbooked card to PGC follow-up.", "owner": "Marketing CA", "timing": "A couple of days if no incoming booking", "basis": "book", "sourcePhotos": [ "IMG_0351", "IMG_0356" ] } ] **branches** [ { "condition": "Card declined", "action": "Thank and leave.", "owner": "Marketing CA", "timing": "Immediately", "nextState": "Closed", "basis": "book", "sourcePhotos": [ "IMG_0351", "IMG_0356" ] }, { "condition": "Phone declined", "action": "Explain purpose and ask permission; if still refused record no phone permission.", "owner": "Marketing CA", "timing": "At capture", "nextState": "Recipient may self-book", "basis": "inferred", "sourcePhotos": [ "IMG_0351", "IMG_0356" ] } ] **completion** "Issuer, card acceptance, contact permission and appointment/follow-up state captured." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-pgc-handout" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." }, { "action": "Cancel pending outbound PGC task when a matching inbound booking occurs.", "basis": "inferred", "rationale": "Avoid duplicate follow-up after the requested action is done." } ] **states** [ "Offered", "Accepted", "Activated", "Awaiting self-book", "Follow-up due", "Booked", "Declined" ] **gaps** [ "Exact “couple days” convention and unsuccessful-call cadence not defined.", "Form has referral/business contacts but no consent wording." ] **clinicalBoundary** "Referral contact supplied by someone else is not recipient consent. Proposed contact eligibility and refusal/suppression controls require approved policy; do not expose patient health details publicly. Advertised scarcity and value must be factual." ### grow-pgc-call · Gift-certificate conversion call Sources: IMG_0352, IMG_0367 Trigger: Accepted PGC remains unbooked or recipient calls in Owner: Marketing / Reception Purpose: Book gift recipients while explaining the two-day structure and massage expectations. **preconditions** [] **steps** [ { "action": "Identify giver and gift package; offer times and ask health concerns.", "owner": "Marketing / Reception", "timing": "At contact", "basis": "book", "sourcePhotos": [ "IMG_0352", "IMG_0367" ] }, { "action": "Use Primary Script; schedule first appointment.", "owner": "Marketing / Reception", "timing": "Same conversation", "basis": "book", "sourcePhotos": [ "IMG_0352", "IMG_0367" ] }, { "action": "Explain Day 1 evaluation and Day 2 report plus massage; answer questions, give directions, repeat date/time.", "owner": "Marketing / Reception", "timing": "Before ending", "basis": "book", "sourcePhotos": [ "IMG_0352", "IMG_0367" ] } ] **branches** [ { "condition": "Already booked", "action": "Confirm appointment and stop conversion sequence.", "owner": "Reception", "timing": "On record match", "nextState": "Booked", "basis": "inferred", "sourcePhotos": [ "IMG_0352", "IMG_0367" ] }, { "condition": "No concern/declines", "action": "Use applicable Primary Script closure and respect decline.", "owner": "Marketing / Reception", "timing": "Same conversation", "nextState": "Closed", "basis": "book", "sourcePhotos": [ "IMG_0352", "IMG_0367" ] } ] **completion** "Day 1 booked, patient informed of two-day process, directions sent/given." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-pgc-call", "grow-pgc-call-30" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Awaiting contact", "Discussing concerns", "Booked Day 1", "Closed" ] **gaps** [ "Versions differ: one books before symptom discussion, another after; massage is “set up” versus “receive” on Day 2.", "30-minute massage stated only in variant; current offer needs decision." ] **clinicalBoundary** "Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation. Historical fees, discounts, free services and donation offers are source examples, not approved current terms. Review actual pricing, eligibility, payer rules and consent before use; no automatic charging or pressure for financial disclosure." ### grow-screening · Monthly screening and health-fair lead capture Sources: IMG_0353, IMG_0354, IMG_0355, IMG_0377, IMG_0378 Trigger: Monthly marketing calendar planning or fair opportunity received Owner: Marketing director / PRCA / Doctor Purpose: Maintain monthly community event presence and close the lead-to-call handoff. **preconditions** [] **steps** [ { "action": "Find fairs via businesses/churches/cities/patient employers and HR/safety contacts.", "owner": "Marketing director / PRCA / Doctor", "timing": "Planning; at least one screening and one fair/month source goals", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0354", "IMG_0355", "IMG_0377", "IMG_0378" ] }, { "action": "Arrange representation; capture venue, date/time, topic, time allowed, expected attendance and offered service.", "owner": "Marketing director / PRCA / Doctor", "timing": "Before event", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0354", "IMG_0355", "IMG_0377", "IMG_0378" ] }, { "action": "Prepare survey, contact capture, offer/raffle materials and staffing.", "owner": "Marketing director / PRCA / Doctor", "timing": "Before event", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0354", "IMG_0355", "IMG_0377", "IMG_0378" ] }, { "action": "At event use stress survey and Primary Script, collect leads and book appropriate evaluations.", "owner": "Marketing director / PRCA / Doctor", "timing": "During event", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0354", "IMG_0355", "IMG_0377", "IMG_0378" ] }, { "action": "Organize all contacts; call all leads and ensure opportunities retain scheduling follow-through.", "owner": "Marketing director / PRCA / Doctor", "timing": "After event", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0354", "IMG_0355", "IMG_0377", "IMG_0378" ] } ] **branches** [] **completion** "Event delivered; every lead assigned and every event inquiry scheduled/closed/has next action." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [ "Inferred: unscheduled eligible opportunities surface in marketing manager queue; due threshold remains to be approved." ] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." }, { "action": "Recurring event targets and event checklist with lead reconciliation count.", "basis": "inferred", "rationale": "Makes source monthly obligations and follow-up-all-leads observable." } ] **states** [ "Opportunity", "Contact identified", "Meeting set", "Event scheduled", "Prepared", "Delivered", "Leads assigned", "Reconciled" ] **gaps** [ "Screening and health fair may be same event; no rule states whether double counting is acceptable.", "No no-response retry cadence for business leads." ] **clinicalBoundary** "Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation. Referral contact supplied by someone else is not recipient consent. Proposed contact eligibility and refusal/suppression controls require approved policy; do not expose patient health details publicly. Advertised scarcity and value must be factual." ### grow-business-outreach · Business contact, five-minute needs meeting and event booking Sources: IMG_0353, IMG_0354, IMG_0355, IMG_0373, IMG_0377, IMG_0378 Trigger: Patient supplies employer/group lead, cold outreach block or business inquiry Owner: Marketing director then Doctor Purpose: Turn employer/community introductions into a fully specified talk, screening or service event. **preconditions** [] **steps** [ { "action": "Seek employer/club/church introductions during conversations; ask manager/safety contact or call business leads.", "owner": "Marketing director then Doctor", "timing": "Weekly", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0354", "IMG_0355", "IMG_0373", "IMG_0377", "IMG_0378" ] }, { "action": "Contact HR/safety, explain donated service and book doctor meeting.", "owner": "Marketing director then Doctor", "timing": "Four outside meetings/week target in source", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0354", "IMG_0355", "IMG_0373", "IMG_0377", "IMG_0378" ] }, { "action": "Run needs meeting and choose lecture/lunch-and-learn/ergonomics/screening/fair/consultation.", "owner": "Marketing director then Doctor", "timing": "At meeting", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0354", "IMG_0355", "IMG_0373", "IMG_0377", "IMG_0378" ] }, { "action": "Record time, location, topic, allowed duration, attendees and offered service; schedule event.", "owner": "Marketing director then Doctor", "timing": "Before meeting closed", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0354", "IMG_0355", "IMG_0373", "IMG_0377", "IMG_0378" ] }, { "action": "Deliver talks even for small groups; follow all lead and event opportunities.", "owner": "Marketing director then Doctor", "timing": "Two outside lectures/week target; weekly outside event also specified", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0354", "IMG_0355", "IMG_0373", "IMG_0377", "IMG_0378" ] } ] **branches** [] **completion** "Business meeting yields scheduled event with complete logistics or explicit declined/deferred outcome." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-business-intro" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." }, { "action": "Business/contact/event pipeline with overdue next-action queue and linked source script.", "basis": "inferred", "rationale": "Source says organize all contacts and leave none unscheduled." } ] **states** [ "Lead", "HR identified", "Contacted", "Doctor meeting scheduled", "Needs assessed", "Event scheduled", "Delivered", "Follow-up complete" ] **gaps** [ "Source has 4 meetings/week, 2 lectures/week and 1 outside event/week; distinguish planning targets before configuration.", "No nonprofit speakers bureau credentials supplied; verify before claiming membership." ] **clinicalBoundary** "Referral contact supplied by someone else is not recipient consent. Proposed contact eligibility and refusal/suppression controls require approved policy; do not expose patient health details publicly. Advertised scarcity and value must be factual. Doctor must approve educational and ergonomic clinical claims." ### grow-advanced-talk · Monthly advanced talk and patient education attendance Sources: IMG_0353, IMG_0354, IMG_0357, IMG_0373, IMG_0374 Trigger: Annual/monthly education calendar and new enrollment Owner: Marketing / Reception / Doctor Purpose: Plan education talks, invite patients and track the source orientation/special-topic obligations. **preconditions** [] **steps** [ { "action": "Schedule monthly advanced talk; choose nutrition/exercise/stress/time management or other approved topic.", "owner": "Marketing / Reception / Doctor", "timing": "At least one month ahead", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0354", "IMG_0357", "IMG_0373", "IMG_0374" ] }, { "action": "Announce next topic at prior talk; display signups for next three and invite appropriate patients.", "owner": "Marketing / Reception / Doctor", "timing": "Month prior and continuing", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0354", "IMG_0357", "IMG_0373", "IMG_0374" ] }, { "action": "Schedule new-patient orientation every two weeks and patients who have not attended.", "owner": "Marketing / Reception / Doctor", "timing": "Fortnightly", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0354", "IMG_0357", "IMG_0373", "IMG_0374" ] }, { "action": "Track two special-topic talks/year source expectation.", "owner": "Marketing / Reception / Doctor", "timing": "Throughout year", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0354", "IMG_0357", "IMG_0373", "IMG_0374" ] }, { "action": "Present welcome, information, approved clinical tie-in and gift evaluation offer.", "owner": "Marketing / Reception / Doctor", "timing": "At talk", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0354", "IMG_0357", "IMG_0373", "IMG_0374" ] }, { "action": "Book attendee/family evaluations preferably immediately after, otherwise later.", "owner": "Marketing / Reception / Doctor", "timing": "After talk", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0354", "IMG_0357", "IMG_0373", "IMG_0374" ] } ] **branches** [] **completion** "Talk delivered, attendance recorded, nonattenders/next topics assigned and accepted evaluations booked." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." }, { "action": "Attendance ledger links education tasks to patient care checklist; reminders may accompany required calls.", "basis": "inferred", "rationale": "Digitizes source signup sheets and stated attendance expectations." } ] **states** [ "Planned", "Promoting", "Registered", "Attended", "Missed—follow-up", "Evaluation offered", "Complete" ] **gaps** [ "No missed-orientation recovery cadence; no definition of two talks within calendar vs rolling year.", "Monthly (12/year) and 8–12/year both appear; owner must resolve." ] **clinicalBoundary** "Education attendance should support informed participation. Clinical topics including vaccines/cancer require licensed review; do not auto-send unverified medical advice or make consent contingent on marketing participation." ### grow-event-setup · In-office event countdown and room readiness Sources: IMG_0357 Trigger: In-office talk/event scheduled Owner: Marketing coordinator / Support staff Purpose: Make advance staff preparation and exact event start setup assigned and checkable. **preconditions** [] **steps** [ { "action": "Set event calendar and staff briefing.", "owner": "Marketing coordinator / Support staff", "timing": "At least one month ahead", "basis": "book", "sourcePhotos": [ "IMG_0357" ] }, { "action": "Prepare décor, board, posters, handouts and staff knowledge of who/why/when.", "owner": "Marketing coordinator / Support staff", "timing": "At least two weeks before through event", "basis": "book", "sourcePhotos": [ "IMG_0357" ] }, { "action": "Coordinate adjustments before 6 p.m.; at 6 move tables 2/3, retain 1, face chairs to board, stage handouts/easel/flipchart/marker/eraser and clean board.", "owner": "Marketing coordinator / Support staff", "timing": "Typical Tue/Wed 6 p.m.", "basis": "book", "sourcePhotos": [ "IMG_0357" ] }, { "action": "Move late adjustment patients to exam rooms; start event.", "owner": "Marketing coordinator / Support staff", "timing": "6:15 p.m.", "basis": "book", "sourcePhotos": [ "IMG_0357" ] }, { "action": "Collect contact cards for evaluations or HR outreach.", "owner": "Marketing coordinator / Support staff", "timing": "At close", "basis": "book", "sourcePhotos": [ "IMG_0357" ] } ] **branches** [] **completion** "Readiness checklist completed, event starts and contact cards reconciled." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Planned", "Two-week prep", "Day-of ready", "Room ready", "Started", "Contacts collected" ] **gaps** [ "Book office layout and Tue/Wed times are site-specific defaults; current facility must set equivalents." ] **clinicalBoundary** "Do not expose private appointment details in public event view." ### grow-internal-education · Handouts, whiteboards and education distribution Sources: IMG_0354, IMG_0372, IMG_0373 Trigger: Recurring education calendar Owner: Marketing / CA / Reception Purpose: Keep education surfaces refreshed at prescribed recurring intervals. **preconditions** [] **steps** [ { "action": "Prepare approved health articles and testimonials.", "owner": "Marketing / CA / Reception", "timing": "Weekly", "basis": "book", "sourcePhotos": [ "IMG_0354", "IMG_0372", "IMG_0373" ] }, { "action": "Put new handouts on every seat and change whiteboard messages.", "owner": "Marketing / CA / Reception", "timing": "Monday/Wednesday/Friday", "basis": "book", "sourcePhotos": [ "IMG_0354", "IMG_0372", "IMG_0373" ] }, { "action": "Distribute new testimonial handout.", "owner": "Marketing / CA / Reception", "timing": "Monday and Thursday", "basis": "book", "sourcePhotos": [ "IMG_0354", "IMG_0372", "IMG_0373" ] }, { "action": "Display approved video testimonials and education in office rooms.", "owner": "Marketing / CA / Reception", "timing": "During office operations", "basis": "book", "sourcePhotos": [ "IMG_0354", "IMG_0372", "IMG_0373" ] }, { "action": "Align themes, decorations, newsletters and other materials with coming events.", "owner": "Marketing / CA / Reception", "timing": "Event/theme calendar", "basis": "book", "sourcePhotos": [ "IMG_0354", "IMG_0372", "IMG_0373" ] } ] **branches** [] **completion** "Dated content/version and physical distribution/display check completed." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Content selected", "Approved", "Prepared", "Distributed", "Archived" ] **gaps** [ "Monday/Thursday testimonials vs M/W/F general handouts are distinct obligations, not substitutes.", "No newsletter/press/email/fax frequency supplied." ] **clinicalBoundary** "Require patient authorization and clinical/marketing review before displaying claims or identifiable stories." ### grow-internal-referrals · Referral invitation at report, finance, re-exam and improvement Sources: IMG_0349, IMG_0356, IMG_0373, IMG_0390 Trigger: Post-report waiting, financial agreement complete, re-exam complete or spontaneous reported improvement Owner: Enrollment / CA / Doctor Purpose: Turn named source moments into an optional referral task with accountable follow-through. **preconditions** [] **steps** [ { "action": "Ask family/friend referral at stated positive engagement moments.", "owner": "Enrollment / CA / Doctor", "timing": "After report/finance/re-exam or reported improvement", "basis": "book", "sourcePhotos": [ "IMG_0349", "IMG_0356", "IMG_0373", "IMG_0390" ] }, { "action": "After financial arrangement offer family evaluation and give two certificates.", "owner": "Enrollment / CA / Doctor", "timing": "Enrollment", "basis": "book", "sourcePhotos": [ "IMG_0349", "IMG_0356", "IMG_0373", "IMG_0390" ] }, { "action": "Schedule family within next two weeks where accepted.", "owner": "Enrollment / CA / Doctor", "timing": "Within two weeks source expectation", "basis": "book", "sourcePhotos": [ "IMG_0349", "IMG_0356", "IMG_0373", "IMG_0390" ] }, { "action": "Capture names/phones and business/club/church contacts using source form.", "owner": "Enrollment / CA / Doctor", "timing": "At nomination", "basis": "book", "sourcePhotos": [ "IMG_0349", "IMG_0356", "IMG_0373", "IMG_0390" ] }, { "action": "Route individual leads to invitation process and organization leads to business outreach.", "owner": "Enrollment / CA / Doctor", "timing": "After capture", "basis": "book", "sourcePhotos": [ "IMG_0349", "IMG_0356", "IMG_0373", "IMG_0390" ] } ] **branches** [] **completion** "Each offered referral has accepted/declined outcome and each named lead has owner and next action." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-referral-post-finance" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Referral opportunity", "Asked", "Declined", "Nominated", "Permission review", "Contact scheduled", "Booked" ] **gaps** [ "Source does not specify patient-referral initial-call cadence outside named five-day campaigns." ] **clinicalBoundary** "Referral contact supplied by someone else is not recipient consent. Proposed contact eligibility and refusal/suppression controls require approved policy; do not expose patient health details publicly. Advertised scarcity and value must be factual. Referral participation remains voluntary; clinical care must not depend on providing referrals." ### grow-three-week-promo · Three-week dinner → workshop → patient appreciation campaign Sources: IMG_0353, IMG_0373, IMG_0374, IMG_0375, IMG_0376 Trigger: Alternating-month promotional cycle Owner: Marketing director / Doctor / Reception Purpose: Preserve the multi-event buildup, invitation confirmation loop and lead follow-up. **preconditions** [] **steps** [ { "action": "Schedule dinner, advanced talk one week later and PAD one week after talk.", "owner": "Marketing director / Doctor / Reception", "timing": "Every other month source promo", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0373", "IMG_0374", "IMG_0375", "IMG_0376" ] }, { "action": "Source dinner example reserves 20 slots at$17 charity donation for exam/x-rays/first adjustment; PAD examples are Day 1/2/3 for$12 donation or free beach day. Treat these as separate reviewed offer versions. Source participation thank-you example gives first-place$50 gift certificate and others$5.", "owner": "Marketing director", "timing": "Offer/prize planning before invitations", "basis": "book", "sourcePhotos": [ "IMG_0375", "IMG_0376" ] }, { "action": "Choose about 30 patients; invite 10 plus guests, ask confirmation and replace declines until 10 confirmed.", "owner": "Marketing director / Doctor / Reception", "timing": "Invite two weeks before dinner; confirm within 2–3 days", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0373", "IMG_0374", "IMG_0375", "IMG_0376" ] }, { "action": "Run appreciation, brief introductions/testimonials, meal, doctor story/mission and next-two-week event invitation.", "owner": "Marketing director / Doctor / Reception", "timing": "At dinner", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0373", "IMG_0374", "IMG_0375", "IMG_0376" ] }, { "action": "Collect 3 x 5 referral/talk contacts; accepted guest appointments book tomorrow/Friday before leaving.", "owner": "Marketing director / Doctor / Reception", "timing": "At dinner close", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0373", "IMG_0374", "IMG_0375", "IMG_0376" ] }, { "action": "Convert strong stories to written testimonials; follow contact cards.", "owner": "Marketing director / Doctor / Reception", "timing": "Following dinner and next two weeks", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0373", "IMG_0374", "IMG_0375", "IMG_0376" ] }, { "action": "Run approved advanced workshop and PAD; communicate actual opportunity/capacity/deadline and thank participants.", "owner": "Marketing director / Doctor / Reception", "timing": "Weeks 2/3", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0373", "IMG_0374", "IMG_0375", "IMG_0376" ] } ] **branches** [ { "condition": "Invitee declines or does not confirm by requested date", "action": "Contact next patient in selected pool until ten accept.", "owner": "Marketing director / Doctor / Reception", "timing": "2–3 day confirmation checkpoint", "nextState": "Replacement invite", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0373", "IMG_0374", "IMG_0375", "IMG_0376" ] }, { "condition": "No response to lead-card follow-up", "action": "Keep assigned next action; retry policy needed.", "owner": "Marketing", "timing": "Over following two weeks", "nextState": "Contact pending", "basis": "inferred", "sourcePhotos": [ "IMG_0353", "IMG_0373", "IMG_0374", "IMG_0375", "IMG_0376" ] } ] **completion** "All three events completed, invited guest status resolved, contacts reconciled, gifts/thanks done." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-dinner-offer" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." }, { "action": "Three linked event objects, invitation confirmation tasks, capacity counters and two-week contact reconciliation.", "basis": "inferred", "rationale": "Prevents dinner-generated leads being lost between subsequent events." } ] **states** [ "Planned", "Inviting", "Ten confirmed", "Dinner complete", "Lead follow-up", "Workshop complete", "PAD complete", "Reconciled" ] **gaps** [ "References teleconference details not present.", "Annual 8–12 PADs and alternating-month three-week promos coexist: not every PAD is necessarily in a promo.", "Different donation/offer examples ($17 vs $12/free) are not a single required fee." ] **clinicalBoundary** "Historical fees, discounts, free services and donation offers are source examples, not approved current terms. Review actual pricing, eligibility, payer rules and consent before use; no automatic charging or pressure for financial disclosure. Referral contact supplied by someone else is not recipient consent. Proposed contact eligibility and refusal/suppression controls require approved policy; do not expose patient health details publicly. Advertised scarcity and value must be factual." ### grow-recurring-marketing-calendar · Annual and monthly marketing calendar control Sources: IMG_0353, IMG_0373, IMG_0374, IMG_0377 Trigger: Annual calendar creation and each new month Owner: Marketing director / Office manager Purpose: Keep small recurring practices visible alongside larger campaigns. **preconditions** [] **steps** [ { "action": "Place 8–12 PADs and 8–12 advanced talks, associated dinners and coupon programs.", "owner": "Marketing director / Office manager", "timing": "Year planning", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0373", "IMG_0374", "IMG_0377" ] }, { "action": "Schedule three-card Monday.", "owner": "Marketing director / Office manager", "timing": "First Monday each month", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0373", "IMG_0374", "IMG_0377" ] }, { "action": "Schedule kids/family/charity day.", "owner": "Marketing director / Office manager", "timing": "Third Wednesday each month", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0373", "IMG_0374", "IMG_0377" ] }, { "action": "Arrange weekly outside event, monthly screening/health fair and monthly advanced talk.", "owner": "Marketing director / Office manager", "timing": "Weekly/monthly", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0373", "IMG_0374", "IMG_0377" ] }, { "action": "Schedule lead raffle quarterly or every six months; allow PAD overlap.", "owner": "Marketing director / Office manager", "timing": "Approved quarterly or semiannual cadence", "basis": "book", "sourcePhotos": [ "IMG_0353", "IMG_0373", "IMG_0374", "IMG_0377" ] }, { "action": "Include source referral-coupon offer ($35 exam/x-rays) as a reviewed campaign asset, and the next-two-days free family check associated with dinner; current offer configuration remains pending.", "owner": "Marketing director / Doctor", "timing": "Annual campaign asset planning", "basis": "book", "sourcePhotos": [ "IMG_0374" ] } ] **branches** [] **completion** "Required event types appear on calendar with owner and status; missed obligations surfaced." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Calendar draft", "Approved", "This month planned", "Tasks due", "Completed", "Variance review" ] **gaps** [ "Three-card Monday has name/cadence but no actual instructions in assigned pages.", "Quarterly vs semiannual raffle is an explicit choice; not two simultaneous requirements.", "Targets conflict/overlap with other source cadence pages." ] **clinicalBoundary** "Calendar dates and offers are proposals pending current practice approval." ### grow-partner-network · Professional relationship development Sources: IMG_0355 Trigger: Professional introduction or identified partner Owner: Doctor / Marketing Purpose: Build appropriate reciprocal referral relationships and record permitted appreciation. **preconditions** [] **steps** [ { "action": "Identify complementary professional and explain scope and appropriate reciprocal referral fit.", "owner": "Doctor / Marketing", "timing": "At introduction", "basis": "book", "sourcePhotos": [ "IMG_0355" ] }, { "action": "Offer case discussion/review as relevant and record relationship.", "owner": "Doctor / Marketing", "timing": "Initial discussion", "basis": "book", "sourcePhotos": [ "IMG_0355" ] }, { "action": "Maintain relationship; source requests speaking to Dr. Thomas before any reward or entertaining.", "owner": "Doctor / Marketing", "timing": "Before appreciation spend", "basis": "book", "sourcePhotos": [ "IMG_0355" ] } ] **branches** [] **completion** "Partner contact, agreed referral fit and next action recorded." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Potential partner", "Introduced", "Discussion", "Active relationship", "Review" ] **gaps** [ "No ordinary partner follow-up cadence or criteria for profitability provided." ] **clinicalBoundary** "Patient case/x-ray discussion requires appropriate authorization. Referral gifts and reciprocal arrangements require current professional-policy review; no automatic rewards." ### grow-physician-outreach · Medical-doctor introduction, follow-up and monthly article Sources: IMG_0378 Trigger: Physician prospect list compiled Owner: Doctor Purpose: Run the source soft-sell doctor-to-doctor referral-contact sequence. **preconditions** [] **steps** [ { "action": "Compile GP/orthopedic/neurologist/OBGYN names and addresses.", "owner": "Doctor", "timing": "Before campaign", "basis": "book", "sourcePhotos": [ "IMG_0378" ] }, { "action": "Write short personal introduction seeking appropriate reciprocal referral contact.", "owner": "Doctor", "timing": "Initial outreach", "basis": "book", "sourcePhotos": [ "IMG_0378" ] }, { "action": "Call each nonresponder, restating letter.", "owner": "Doctor", "timing": "Several days later", "basis": "book", "sourcePhotos": [ "IMG_0378" ] }, { "action": "Mail relevant article with handwritten note.", "owner": "Doctor", "timing": "Monthly; never more than once/month", "basis": "book", "sourcePhotos": [ "IMG_0378" ] }, { "action": "Use thank-you note only, no gifts.", "owner": "Doctor", "timing": "As appropriate", "basis": "book", "sourcePhotos": [ "IMG_0378" ] } ] **branches** [ { "condition": "Responds before follow-up", "action": "Route to direct discussion; cancel nonresponder call.", "owner": "Doctor", "timing": "On response", "nextState": "Conversation", "basis": "inferred", "sourcePhotos": [ "IMG_0378" ] } ] **completion** "Introduction, response/call and monthly article or suppression outcomes recorded." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-physician-letter" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Listed", "Letter sent", "Awaiting reply", "Doctor call due", "Relationship discussion", "Monthly article", "Closed" ] **gaps** [ "“Several days” not numerically defined.", "No maximum campaign duration or nonresponse stop count." ] **clinicalBoundary** "Do not use source derogatory framing about physicians; peer communication should be truthful and professional. Source explicitly no gifts; this specific rule overrides general networking reward suggestion for physician campaign." ### grow-lead-raffle · Referral lead raffle intake and reconciliation Sources: IMG_0356, IMG_0374, IMG_0379 Trigger: Approved PAD or periodic raffle opens Owner: Marketing / Office manager Purpose: Record referral credits and route every nominated lead to appropriate follow-up. **preconditions** [] **steps** [ { "action": "Set approved prize and entry window.", "owner": "Marketing / Office manager", "timing": "Quarterly or every six months, or PAD", "basis": "book", "sourcePhotos": [ "IMG_0356", "IMG_0374", "IMG_0379" ] }, { "action": "Capture individual and company/church/group referrals.", "owner": "Marketing / Office manager", "timing": "During campaign", "basis": "book", "sourcePhotos": [ "IMG_0356", "IMG_0374", "IMG_0379" ] }, { "action": "Issue one ticket for individual referral and two for business/church/group-talk referral.", "owner": "Marketing / Office manager", "timing": "At accepted referral", "basis": "book", "sourcePhotos": [ "IMG_0356", "IMG_0374", "IMG_0379" ] }, { "action": "Route all leads and record draw/prize fulfillment.", "owner": "Marketing", "timing": "During/close; fulfillment details inferred", "basis": "inferred", "sourcePhotos": [ "IMG_0379" ] } ] **branches** [] **completion** "Ticket ledger reconciled with referrals, eligible draw recorded, prize/thanks delivered." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Planned", "Open", "Entries recorded", "Follow-ups assigned", "Draw complete", "Closed" ] **gaps** [ "No draw method/eligibility/terms defined." ] **clinicalBoundary** "Referral incentives and raffle participation require current policy review; do not assume historic program is permitted as written." ### grow-testimonial · Patient-story capture, approval and publication Sources: IMG_0371, IMG_0372, IMG_0375, IMG_0379, IMG_0390, IMG_0398 Trigger: Patient reports improvement or appropriate re-exam/event opportunity Owner: CA / Marketing Purpose: Complete the authorization chain before sharing patient stories or photos. **preconditions** [] **steps** [ { "action": "Ask four patient-story questions and record their words or video.", "owner": "CA / Marketing", "timing": "At voluntary testimonial", "basis": "book", "sourcePhotos": [ "IMG_0371", "IMG_0372", "IMG_0375", "IMG_0379", "IMG_0390", "IMG_0398" ] }, { "action": "Ask permission to share; type written story and return for patient review.", "owner": "CA / Marketing", "timing": "Before publication", "basis": "book", "sourcePhotos": [ "IMG_0371", "IMG_0372", "IMG_0375", "IMG_0379", "IMG_0390", "IMG_0398" ] }, { "action": "Obtain signed authorization and file it; take approved photograph.", "owner": "CA / Marketing", "timing": "After approval", "basis": "book", "sourcePhotos": [ "IMG_0371", "IMG_0372", "IMG_0375", "IMG_0379", "IMG_0390", "IMG_0398" ] }, { "action": "Display approved story/photo on wall or approved media; record where used.", "owner": "CA / Marketing", "timing": "After authorization", "basis": "book", "sourcePhotos": [ "IMG_0371", "IMG_0372", "IMG_0375", "IMG_0379", "IMG_0390", "IMG_0398" ] }, { "action": "Use new testimonial handouts and office video only under recorded authorization.", "owner": "CA / Marketing", "timing": "Monday/Thursday and approved display", "basis": "book", "sourcePhotos": [ "IMG_0371", "IMG_0372", "IMG_0375", "IMG_0379", "IMG_0390", "IMG_0398" ] } ] **branches** [ { "condition": "Patient declines or does not approve text", "action": "Do not publish; record declined/pending.", "owner": "CA", "timing": "Before release", "nextState": "Not published", "basis": "inferred", "sourcePhotos": [ "IMG_0371", "IMG_0372", "IMG_0375", "IMG_0379", "IMG_0390", "IMG_0398" ] } ] **completion** "Story approved, authorization filed and publication destinations recorded, or declined outcome." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-testimonial-interview" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Requested", "Captured", "Typed", "Patient review", "Authorized", "Published", "Withdrawn" ] **gaps** [ "Book lacks authorization form wording, expiry/withdrawal and media-use scope." ] **clinicalBoundary** "Do not convert individual testimonial into general medical proof; preserve exact patient account, consent and approved use." ### grow-patient-month · Monthly patient recognition Sources: IMG_0372, IMG_0379 Trigger: Monthly recognition cycle Owner: Office manager / Marketing Purpose: Run patient-of-month selection and approved story/award display. **preconditions** [] **steps** [ { "action": "Select patient based on source criteria of referrals, engagement, appointments and results.", "owner": "Office manager / Marketing", "timing": "Monthly", "basis": "book", "sourcePhotos": [ "IMG_0372", "IMG_0379" ] }, { "action": "Confirm printed story and signed authorization.", "owner": "Office manager / Marketing", "timing": "Before display", "basis": "book", "sourcePhotos": [ "IMG_0372", "IMG_0379" ] }, { "action": "Prepare prominent poster/easel with photo/story.", "owner": "Office manager / Marketing", "timing": "Before presentation", "basis": "book", "sourcePhotos": [ "IMG_0372", "IMG_0379" ] }, { "action": "Present approved gift, photograph with award/chair/gifts and display with permission.", "owner": "Office manager / Marketing", "timing": "Recognition date", "basis": "book", "sourcePhotos": [ "IMG_0372", "IMG_0379" ] } ] **branches** [] **completion** "Selection, consent check, presentation and approved display completed." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Selection due", "Selected", "Permission ready", "Prepared", "Presented", "Complete" ] **gaps** [ "No award budget, selection weights or deadline specified." ] **clinicalBoundary** "Participation, gifts and public health information require approved current policy and informed permission." ### grow-new-year-reactivation · Start the Year Healthy inactive-patient reactivation Sources: IMG_0380, IMG_0381 Trigger: New Year campaign planning; inactive 6 months–2 years cohort Owner: CA with Doctor Purpose: Systematic doctor-screened reactivation with measured mailing capacity and five-day calls. **preconditions** [] **steps** [ { "action": "Print invitations; review inactive list with doctor and exclude doctor-rejected names.", "owner": "CA with Doctor", "timing": "Before campaign", "basis": "book", "sourcePhotos": [ "IMG_0380", "IMG_0381" ] }, { "action": "Personalize card, have office sign and log mailing; maintain personal tidbits.", "owner": "CA with Doctor", "timing": "At send; maximum 10 envelopes/day", "basis": "book", "sourcePhotos": [ "IMG_0380", "IMG_0381" ] }, { "action": "Call using source reactivation script.", "owner": "CA with Doctor", "timing": "Five days after mailing", "basis": "book", "sourcePhotos": [ "IMG_0380", "IMG_0381" ] }, { "action": "Review old/new symptoms, invite return and resolve office upset if disclosed.", "owner": "CA with Doctor", "timing": "During call", "basis": "book", "sourcePhotos": [ "IMG_0380", "IMG_0381" ] }, { "action": "On return obtain Update Form and hand off to clinician for appropriate checkup/report/plan.", "owner": "CA with Doctor", "timing": "At return", "basis": "book", "sourcePhotos": [ "IMG_0380", "IMG_0381" ] }, { "action": "Source doctor return visit includes consultation, checkup and an adrenal check, then a new plan of 12 visits or fewer counting the free visit;15% prepay discount example. These are historical clinical/price instructions requiring current approval, never automatically ordered or charged.", "owner": "Doctor", "timing": "At clinician return-plan decision", "basis": "book", "sourcePhotos": [ "IMG_0380" ] } ] **branches** [ { "condition": "Doctor excludes", "action": "Move to historical inactive/excluded disposition and suppress campaign.", "owner": "CA with Doctor", "timing": "Before send", "nextState": "Excluded", "basis": "book", "sourcePhotos": [ "IMG_0380", "IMG_0381" ] }, { "condition": "Minor existing problem", "action": "Doctor may report same day with prior films.", "owner": "CA with Doctor", "timing": "Return appointment", "nextState": "Report complete", "basis": "book", "sourcePhotos": [ "IMG_0380", "IMG_0381" ] }, { "condition": "New problem", "action": "Clinician decides imaging; source next-day report if new films needed.", "owner": "CA with Doctor", "timing": "Return visit", "nextState": "Report scheduled", "basis": "book", "sourcePhotos": [ "IMG_0380", "IMG_0381" ] }, { "condition": "Not interested and no office upset", "action": "Thank and end.", "owner": "CA with Doctor", "timing": "Call", "nextState": "Declined", "basis": "book", "sourcePhotos": [ "IMG_0380", "IMG_0381" ] }, { "condition": "Office upset", "action": "Try to resolve then offer appointment.", "owner": "CA with Doctor", "timing": "Call", "nextState": "Service recovery", "basis": "book", "sourcePhotos": [ "IMG_0380", "IMG_0381" ] } ] **completion** "Every eligible mailed invitation reaches booked/declined/excluded or owned unresolved status; clinical handoff complete." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-reactivation-newyear" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." }, { "action": "Throttle mail queue at ten/day; generate required telephone task five days after actual mailing, cancel if already booked/declined.", "basis": "inferred", "rationale": "Digitizes explicit source cap/timer and avoids duplicate contact." }, { "action": "Optional approved SMS companion after permitted contact, with booking link and no clinical assumptions.", "basis": "inferred", "rationale": "Modern addition supports but does not replace five-day call." } ] **states** [ "Cohort review", "Excluded", "Approved", "Mailed", "Call due", "Booked", "Declined", "Returned", "Plan decision" ] **gaps** [ "Calendar vs business days unspecified.", "Referenced invitation/update forms from Agenda 2 may not be supplied.", "No unreachable retry count or campaign close date." ] **clinicalBoundary** "Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation. Historical fees, discounts, free services and donation offers are source examples, not approved current terms. Review actual pricing, eligibility, payer rules and consent before use; no automatic charging or pressure for financial disclosure. Referral contact supplied by someone else is not recipient consent. Proposed contact eligibility and refusal/suppression controls require approved policy; do not expose patient health details publicly. Advertised scarcity and value must be factual." ### grow-valentine-reactivation · Valentine inactive-patient invitation and recovery Sources: IMG_0381, IMG_0382, IMG_0383, IMG_0384 Trigger: Valentine seasonal reactivation; inactive 6 months–2 years cohort Owner: CA with Doctor Purpose: Adapt named seasonal campaign while preserving its two-week offer, personal mailing and five-day phone follow-up. **preconditions** [] **steps** [ { "action": "Review cohort/exclusions with doctor; prepare Valentine invitation.", "owner": "CA with Doctor", "timing": "Before campaign", "basis": "book", "sourcePhotos": [ "IMG_0381", "IMG_0382", "IMG_0383", "IMG_0384" ] }, { "action": "Mail signed/personal note with two certificates and tracking record.", "owner": "CA with Doctor", "timing": "Maximum 10/day; gift available next two weeks in letter", "basis": "book", "sourcePhotos": [ "IMG_0381", "IMG_0382", "IMG_0383", "IMG_0384" ] }, { "action": "Call five days after mailing and review old/new problems.", "owner": "CA with Doctor", "timing": "Day 5 after actual send", "basis": "book", "sourcePhotos": [ "IMG_0381", "IMG_0382", "IMG_0383", "IMG_0384" ] }, { "action": "If accepting, schedule even if certificate lost; obtain Update Form on return.", "owner": "CA with Doctor", "timing": "At booking/return", "basis": "book", "sourcePhotos": [ "IMG_0381", "IMG_0382", "IMG_0383", "IMG_0384" ] }, { "action": "Use clinician minor/new-problem branches and approved plan decision.", "owner": "CA with Doctor", "timing": "At return", "basis": "book", "sourcePhotos": [ "IMG_0381", "IMG_0382", "IMG_0383", "IMG_0384" ] }, { "action": "Source doctor return visit includes consultation, checkup and an adrenal check, then a new plan of 12 visits or fewer counting the free visit;15% prepay discount example. These are historical clinical/price instructions requiring current approval, never automatically ordered or charged.", "owner": "Doctor", "timing": "At clinician return-plan decision", "basis": "book", "sourcePhotos": [ "IMG_0383" ] } ] **branches** [ { "condition": "No gift wanted", "action": "Offer phone record update; respect refusal.", "owner": "CA with Doctor", "timing": "At response", "nextState": "Records updated or declined", "basis": "book", "sourcePhotos": [ "IMG_0381", "IMG_0382", "IMG_0383", "IMG_0384" ] }, { "condition": "Certificate lost", "action": "Book anyway.", "owner": "CA with Doctor", "timing": "At contact", "nextState": "Booked", "basis": "book", "sourcePhotos": [ "IMG_0381", "IMG_0382", "IMG_0383", "IMG_0384" ] }, { "condition": "Office upset", "action": "Handle and retry invitation if appropriate.", "owner": "CA with Doctor", "timing": "During call", "nextState": "Service recovery", "basis": "book", "sourcePhotos": [ "IMG_0381", "IMG_0382", "IMG_0383", "IMG_0384" ] }, { "condition": "No upset and no interest", "action": "Thank and end.", "owner": "CA with Doctor", "timing": "During call", "nextState": "Declined", "basis": "book", "sourcePhotos": [ "IMG_0381", "IMG_0382", "IMG_0383", "IMG_0384" ] } ] **completion** "Cohort resolved with send/call/booking/decline evidence and updates as accepted." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-valentine-letter", "grow-reactivation-valentine" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Screened", "Ready", "Mailed", "Call due", "Booked", "Declined", "Updated", "Returned" ] **gaps** [ "Source copied Start the Year Healthy title into mailing step and script; choose approved Valentine-specific copy while preserving original evidence.", "Referenced forms not present in assigned pages.", "Day counting and retry cadence unspecified." ] **clinicalBoundary** "Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation. Historical fees, discounts, free services and donation offers are source examples, not approved current terms. Review actual pricing, eligibility, payer rules and consent before use; no automatic charging or pressure for financial disclosure. Source adrenal tests, caffeine/vitamin and stress-disease claims are not approved diagnostic rules." ### grow-charity-campaign · Have a Heart charity referral campaign Sources: IMG_0385, IMG_0386, IMG_0387 Trigger: Approved Valentine charity campaign Owner: Marketing / CA Purpose: Coordinate materials, voluntary donations, patient-signed introductions, mailing and calls. **preconditions** [] **steps** [ { "action": "Select local charity and prepare flyer, card letter, certificate and roses.", "owner": "Marketing / CA", "timing": "Before campaign", "basis": "book", "sourcePhotos": [ "IMG_0385", "IMG_0386", "IMG_0387" ] }, { "action": "Hand out flyer two weeks before Valentine’s Day; give adult patient flower day before.", "owner": "Marketing / CA", "timing": "Two-week runway/day before", "basis": "book", "sourcePhotos": [ "IMG_0385", "IMG_0386", "IMG_0387" ] }, { "action": "Use no-pressure invitation; source donation 5–20 dollars yields gifted consultation/checkup/massage.", "owner": "Marketing / CA", "timing": "Patient invitation", "basis": "book", "sourcePhotos": [ "IMG_0385", "IMG_0386", "IMG_0387" ] }, { "action": "Help patient nominate person, capture name/address/phone and obtain signed/personal letter.", "owner": "Marketing / CA", "timing": "If participating", "basis": "book", "sourcePhotos": [ "IMG_0385", "IMG_0386", "IMG_0387" ] }, { "action": "Handwrite envelope, stamp/mail and record send.", "owner": "Marketing / CA", "timing": "After nomination", "basis": "book", "sourcePhotos": [ "IMG_0385", "IMG_0386", "IMG_0387" ] }, { "action": "Call recipient to explain gift,45 minute appointment and book preferred time; offer family extension if self-only.", "owner": "Marketing / CA", "timing": "Five days after mailing", "basis": "book", "sourcePhotos": [ "IMG_0385", "IMG_0386", "IMG_0387" ] }, { "action": "Create donation press release and record acknowledgment.", "owner": "Marketing / CA", "timing": "After donation results", "basis": "book", "sourcePhotos": [ "IMG_0385", "IMG_0386", "IMG_0387" ] } ] **branches** [ { "condition": "Patient declines donation/participation", "action": "Respect no-pressure choice and close invitation.", "owner": "Marketing / CA", "timing": "Immediately", "nextState": "Declined", "basis": "book", "sourcePhotos": [ "IMG_0385", "IMG_0386", "IMG_0387" ] }, { "condition": "No recipient in mind", "action": "Use source prompts to help identify a person; no invention of diagnosis.", "owner": "Marketing / CA", "timing": "During invitation", "nextState": "Nomination or declined", "basis": "book", "sourcePhotos": [ "IMG_0385", "IMG_0386", "IMG_0387" ] }, { "condition": "Recipient accepts", "action": "Book and route Day 1/reminder.", "owner": "Marketing / CA", "timing": "On call", "nextState": "Booked", "basis": "book", "sourcePhotos": [ "IMG_0385", "IMG_0386", "IMG_0387" ] } ] **completion** "Donation accounting, signed letter, send/call outcome and accepted booking are recorded; campaign press release approved." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-charity-invite", "grow-charity-call" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Prepared", "Invited", "Donation accepted", "Recipient nominated", "Signed", "Mailed", "Call due", "Booked", "Declined", "Reconciled" ] **gaps** [ "No donation handling/accounting method, consent standard or missed-call retry cadence specified.", "Rose vendor/price and comparison pricing historical." ] **clinicalBoundary** "Historical fees, discounts, free services and donation offers are source examples, not approved current terms. Review actual pricing, eligibility, payer rules and consent before use; no automatic charging or pressure for financial disclosure. Referral contact supplied by someone else is not recipient consent. Proposed contact eligibility and refusal/suppression controls require approved policy; do not expose patient health details publicly. Advertised scarcity and value must be factual. Clinical claims in invitation must be reviewed." ### grow-family-day · Family Health Week referral delivery and booking Sources: IMG_0388, IMG_0389, IMG_0390 Trigger: Family Day/week campaign active Owner: CA / Reception Purpose: Use family-history conversation, choose delivery route and close every five-day follow-up. **preconditions** [] **steps** [ { "action": "Display poster, prepare flyer/history/referral forms and staff Ask me about Family Day tags.", "owner": "CA / Reception", "timing": "Before event", "basis": "book", "sourcePhotos": [ "IMG_0388", "IMG_0389", "IMG_0390" ] }, { "action": "If patient feeling well, give clipboard materials; review local family and requested evaluations.", "owner": "CA / Reception", "timing": "At invitation", "basis": "book", "sourcePhotos": [ "IMG_0388", "IMG_0389", "IMG_0390" ] }, { "action": "Offer tentative appointment using actual capacity; collect recipient phone.", "owner": "CA / Reception", "timing": "At nomination", "basis": "book", "sourcePhotos": [ "IMG_0388", "IMG_0389", "IMG_0390" ] }, { "action": "Co-resident: patient delivers material; otherwise office mails handwritten envelope or patient chooses direct delivery.", "owner": "CA / Reception", "timing": "After nomination", "basis": "book", "sourcePhotos": [ "IMG_0388", "IMG_0389", "IMG_0390" ] }, { "action": "Call to explain gift/45 minute evaluation, give directions and book; ask about another family member if self-only.", "owner": "CA / Reception", "timing": "Five days later", "basis": "book", "sourcePhotos": [ "IMG_0388", "IMG_0389", "IMG_0390" ] } ] **branches** [ { "condition": "Appointment tentatively made by referring patient", "action": "Seek recipient confirmation before treating as booked/confirmed.", "owner": "Reception", "timing": "At recipient contact", "nextState": "Confirmed or declined", "basis": "inferred", "sourcePhotos": [ "IMG_0388", "IMG_0389", "IMG_0390" ] }, { "condition": "Co-resident", "action": "Give materials to patient instead of mailing.", "owner": "CA / Reception", "timing": "At nomination", "nextState": "Hand delivery", "basis": "book", "sourcePhotos": [ "IMG_0388", "IMG_0389", "IMG_0390" ] } ] **completion** "Referral has delivery event, contact eligibility, five-day-call outcome and confirmed/declined booking state." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-family-invite", "grow-family-call" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Materials ready", "Patient invited", "Family nominated", "Tentative", "Delivered", "Call due", "Confirmed", "Declined" ] **gaps** [ "For hand delivery the five-day timer anchor is not explicit; proposed recorded delivery date.", "No template copies of referenced Agenda 2 forms here." ] **clinicalBoundary** "Referral contact supplied by someone else is not recipient consent. Proposed contact eligibility and refusal/suppression controls require approved policy; do not expose patient health details publicly. Advertised scarcity and value must be factual. Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation." ### grow-enrollment-priority · Enrollment capacity and priority queue Sources: IMG_0358 Trigger: Enrollment work queue assessed Owner: Enrollment / Doctor Purpose: Keep enrollment attention on patient-facing core work and explicitly surface secondary-duty overload. **preconditions** [] **steps** [ { "action": "Prioritize in-room Day 1/2/3/re-sign/Room 4 work.", "owner": "Enrollment / Doctor", "timing": "First priority", "basis": "book", "sourcePhotos": [ "IMG_0358" ] }, { "action": "Prepare for those appointments.", "owner": "Enrollment / Doctor", "timing": "Second priority", "basis": "book", "sourcePhotos": [ "IMG_0358" ] }, { "action": "Set new Day 1/2/3/re-sign appointments.", "owner": "Enrollment / Doctor", "timing": "Third priority", "basis": "book", "sourcePhotos": [ "IMG_0358" ] }, { "action": "If core work fills capacity and secondary work remains undone, discuss with doctor to arrange coverage.", "owner": "Enrollment / Doctor", "timing": "When overloaded", "basis": "book", "sourcePhotos": [ "IMG_0358" ] } ] **branches** [] **completion** "Priority work assigned and capacity exception has doctor-approved coverage." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Queued", "Prioritized", "In progress", "Capacity exception", "Reassigned", "Done" ] **gaps** [ "No numeric capacity threshold or secondary-duty list here." ] **clinicalBoundary** "Administrative prioritization only." ### grow-financial · Financial arrangement and four-option decision Sources: IMG_0359, IMG_0360 Trigger: After ROF, plan end requiring next plan, or Room 4 financial review Owner: Enrollment / Doctor Purpose: Explain recommended care and full cost before finding an accepted payment or care-plan path. **preconditions** [] **steps** [ { "action": "Sit beside patient; review recommended visits and Corrective Care Plan and Financial Summary.", "owner": "Enrollment / Doctor", "timing": "Before options", "basis": "book", "sourcePhotos": [ "IMG_0359", "IMG_0360" ] }, { "action": "Present source one-time payment and 20% example discount with dollar savings.", "owner": "Enrollment / Doctor", "timing": "First option", "basis": "book", "sourcePhotos": [ "IMG_0359", "IMG_0360" ] }, { "action": "If not chosen, cross out that option and discuss down payment plus monthly balance; six-month initial illustration, extend if agreed.", "owner": "Enrollment / Doctor", "timing": "Second option", "basis": "book", "sourcePhotos": [ "IMG_0359", "IMG_0360" ] }, { "action": "If affordability unresolved, ask optional finances discussion; use modified budget plan if appropriate.", "owner": "Enrollment / Doctor", "timing": "Third option", "basis": "book", "sourcePhotos": [ "IMG_0359", "IMG_0360" ] }, { "action": "Modified-plan source terms: exams and rehab at no cost, x-rays $30 each; source doubles home exercise from 15 to 30 minutes morning and evening. Preserve as historical terms; clinician must approve exercise and current pricing before any working plan.", "owner": "Enrollment / Doctor", "timing": "Only within source modified-plan branch", "basis": "book", "sourcePhotos": [ "IMG_0360" ] }, { "action": "If not ready/full plan declined, offer three ordinary-fee visits and later reassess willingness.", "owner": "Enrollment / Doctor", "timing": "Fourth/limited-trial path", "basis": "book", "sourcePhotos": [ "IMG_0359", "IMG_0360" ] }, { "action": "Get doctor if staff cannot resolve.", "owner": "Enrollment / Doctor", "timing": "Before ending unresolved meeting", "basis": "book", "sourcePhotos": [ "IMG_0359", "IMG_0360" ] } ] **branches** [ { "condition": "Modified plan appropriate", "action": "Compute yearly budget=down+12 monthly, convert using approved fee and clinician-approved plan. Source example 1400/55→25 visits.", "owner": "Enrollment / Doctor", "timing": "At agreement", "nextState": "Modified plan", "basis": "book", "sourcePhotos": [ "IMG_0359", "IMG_0360" ] }, { "condition": "Wants time to consider", "action": "Acknowledge, ask unanswered questions; source offers trial. Preserve voluntary decision and defer option.", "owner": "Enrollment / Doctor", "timing": "At objection", "nextState": "Consideration or trial", "basis": "book", "sourcePhotos": [ "IMG_0359", "IMG_0360" ] }, { "condition": "Three visits completed and patient wants more", "action": "Meet again for longer arrangement.", "owner": "Enrollment / Doctor", "timing": "After third visit", "nextState": "New arrangement", "basis": "book", "sourcePhotos": [ "IMG_0359", "IMG_0360" ] }, { "condition": "No arrangement possible", "action": "Get doctor with source handoff line.", "owner": "Enrollment / Doctor", "timing": "Same encounter", "nextState": "Doctor review", "basis": "book", "sourcePhotos": [ "IMG_0359", "IMG_0360" ] } ] **completion** "Patient receives cost/option explanation and documented accepted terms or voluntary declined/deferred decision." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-finance", "grow-finance-modified" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." }, { "action": "Prepare comparison calculations and document choice; no recurring charge until signed current terms.", "basis": "inferred", "rationale": "Source worksheet becomes reviewed financial record." } ] **states** [ "Recommended plan ready", "Full cost explained", "Options reviewed", "One-time", "Monthly", "Modified", "Trial", "Deferred", "Doctor review", "Declined" ] **gaps** [ "Current prices/discounts, payer exceptions, refunds, plan-change rules and consent not provided.", "Source treats financial nondisclosure as lack of commitment; proposed system must not make that assumption." ] **clinicalBoundary** "Historical fees, discounts, free services and donation offers are source examples, not approved current terms. Review actual pricing, eligibility, payer rules and consent before use; no automatic charging or pressure for financial disclosure. Exercise increase and modified visit totals require clinician approval; a budget does not prescribe necessary care." ### grow-phone-coverage · Phone coverage, triage and message handoff Sources: IMG_0362 Trigger: Office phone ring or incoming message Owner: Receptionist coordinates all team members Purpose: Make incoming-call ownership and complete messages reliable. **preconditions** [] **steps** [ { "action": "Staff phones Monday–Friday 8–5 and answer by third ring with source greeting.", "owner": "Receptionist coordinates all team members", "timing": "Each incoming call", "basis": "book", "sourcePhotos": [ "IMG_0362" ] }, { "action": "Ask caller identity and subject; record from/to/date/details/staff initials.", "owner": "Receptionist coordinates all team members", "timing": "When message needed", "basis": "book", "sourcePhotos": [ "IMG_0362" ] }, { "action": "If recipient with patient, promise message and route it.", "owner": "Receptionist coordinates all team members", "timing": "At call", "basis": "book", "sourcePhotos": [ "IMG_0362" ] }, { "action": "If emergency, hold and get recipient immediately.", "owner": "Receptionist coordinates all team members", "timing": "Emergency branch", "basis": "book", "sourcePhotos": [ "IMG_0362" ] } ] **branches** [] **completion** "Call answered/routed or complete message assigned; recipient acknowledgment is proposed." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-phone-message" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." }, { "action": "Missed-call/callback work item and unacknowledged-message queue with role fallback.", "basis": "inferred", "rationale": "Extends book’s phone ownership/message record into accountable digital handoff." } ] **states** [ "Incoming", "Answered", "Message recorded", "Routed", "Acknowledged", "Closed" ] **gaps** [ "No emergency triage protocol or callback SLA beyond ring target." ] **clinicalBoundary** "Current emergency procedure must be clinician-approved; staff must not independently diagnose urgency." ### grow-new-patient-booking · New-patient inbound booking and enrollment handoff Sources: IMG_0362, IMG_0366 Trigger: Incoming caller seeks appointment and has never visited Owner: Reception / CA Purpose: Capture necessary booking/referral/injury details and prepare correct arrival workflow. **preconditions** [] **steps** [ { "action": "Determine last visit, self/family scope, name and phone.", "owner": "Reception / CA", "timing": "At call", "basis": "book", "sourcePhotos": [ "IMG_0362", "IMG_0366" ] }, { "action": "Offer morning/afternoon then next two day/time choices.", "owner": "Reception / CA", "timing": "Booking", "basis": "book", "sourcePhotos": [ "IMG_0362", "IMG_0366" ] }, { "action": "Record referral source; plan thanks for named referrer next visit.", "owner": "Reception / CA", "timing": "Booking", "basis": "book", "sourcePhotos": [ "IMG_0362", "IMG_0366" ] }, { "action": "Ask auto/work injury and flag additional arrival forms; request insurance details brought for benefits check.", "owner": "Reception / CA", "timing": "Before close", "basis": "book", "sourcePhotos": [ "IMG_0362", "IMG_0366" ] }, { "action": "Give directions and close; collect all phone numbers on arrival.", "owner": "Reception / CA", "timing": "Before close/arrival", "basis": "book", "sourcePhotos": [ "IMG_0362", "IMG_0366" ] }, { "action": "For repeated price questions use source responses and relay quoted expectation to enrollment.", "owner": "Reception / CA", "timing": "If asked", "basis": "book", "sourcePhotos": [ "IMG_0362", "IMG_0366" ] } ] **branches** [] **completion** "Booked patient with attribution, family scope, injury/insurance preparation, directions and price-question note." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-new-patient-phone", "grow-price-inquiry" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "New caller", "Captured", "Slot selected", "Preparation recorded", "Booked", "Arrived" ] **gaps** [ "Source telephone fee-avoidance policy requires current transparency decision; no rates supplied." ] **clinicalBoundary** "Historical fees, discounts, free services and donation offers are source examples, not approved current terms. Review actual pricing, eligibility, payer rules and consent before use; no automatic charging or pressure for financial disclosure. Emergency/symptom questions requiring clinical judgment route to clinician." ### grow-day1-reminder · Day 1 reminder call Sources: IMG_0350, IMG_0361, IMG_0367 Trigger: Day 1 appointment approaching Owner: Reception Purpose: Confirm arrival logistics early enough for patients to adjust plans. **preconditions** [] **steps** [ { "action": "Call using appointment/directions prompt.", "owner": "Reception", "timing": "Night before or early enough for schedule changes", "basis": "book", "sourcePhotos": [ "IMG_0350", "IMG_0361", "IMG_0367" ] }, { "action": "Live answer: confirm logistics and attending companion as relevant.", "owner": "Reception", "timing": "At answer", "basis": "book", "sourcePhotos": [ "IMG_0350", "IMG_0361", "IMG_0367" ] }, { "action": "Voicemail: office, scheduled time, directions offer, callback and expected arrival.", "owner": "Reception", "timing": "If no answer", "basis": "book", "sourcePhotos": [ "IMG_0350", "IMG_0361", "IMG_0367" ] } ] **branches** [ { "condition": "Forgotten or trying to cancel", "action": "Explore concern and use approved Primary Script if appropriate; reschedule/record decline.", "owner": "Reception", "timing": "During call", "nextState": "Reconfirmed/rescheduled/declined", "basis": "book", "sourcePhotos": [ "IMG_0350", "IMG_0361", "IMG_0367" ] } ] **completion** "Call outcome and confirmed/rescheduled/declined/unreachable status recorded." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-day1-reminder", "grow-early-stage-calls" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." }, { "action": "Consent-based SMS reminder/directions link may accompany required call and self-rescheduling link.", "basis": "inferred", "rationale": "Modern convenience preserves book’s human phone touchpoint." } ] **states** [ "Scheduled", "Call due", "Attempted", "Confirmed", "Rescheduled", "Declined", "Unreachable" ] **gaps** [ "No reminder retry frequency." ] **clinicalBoundary** "Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation. Appointment messages must follow approved privacy preferences." ### grow-day1-missed · Missed Day 1 recovery Sources: IMG_0361, IMG_0367, IMG_0369 Trigger: Scheduled Day 1 not attended Owner: Reception / Marketing / Enrollment Purpose: Recover missed first appointment and record actual reason. **preconditions** [] **steps** [ { "action": "Call source missed-you/is-everything-alright prompt.", "owner": "Reception / Marketing / Enrollment", "timing": "On missed appointment; general 20 minute rule relevant", "basis": "book", "sourcePhotos": [ "IMG_0361", "IMG_0367", "IMG_0369" ] }, { "action": "Explore concerns using approved Primary Script whether patient reschedules or not.", "owner": "Reception / Marketing / Enrollment", "timing": "During contact", "basis": "book", "sourcePhotos": [ "IMG_0361", "IMG_0367", "IMG_0369" ] }, { "action": "Record name/number in computer recovery pool and keep owner.", "owner": "Reception / Marketing / Enrollment", "timing": "Each day; source red-book reconciliation", "basis": "book", "sourcePhotos": [ "IMG_0361", "IMG_0367", "IMG_0369" ] } ] **branches** [ { "condition": "Reschedules", "action": "Record new Day 1 and stop stale missed-visit tasks.", "owner": "Reception", "timing": "On acceptance", "nextState": "Rescheduled", "basis": "inferred", "sourcePhotos": [ "IMG_0361", "IMG_0367", "IMG_0369" ] }, { "condition": "Unable to solve/bring back", "action": "Record notes and hand to quality control.", "owner": "Reception / Marketing / Enrollment", "timing": "After unresolved recovery", "nextState": "QC review", "basis": "book", "sourcePhotos": [ "IMG_0361", "IMG_0367", "IMG_0369" ] } ] **completion** "Booked new appointment, refusal recorded or QC accepts unresolved case." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-early-stage-calls", "grow-primary" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Missed", "Call due", "Contacted", "Rescheduled", "Declined", "QC review" ] **gaps** [ "Source assertion that weak script caused no-show is not a diagnosis; discover actual cause.", "No retry cadence specified." ] **clinicalBoundary** "Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation." ### grow-day2-followthrough · Day 2 report confirmation and missed-report recovery Sources: IMG_0361, IMG_0367 Trigger: Day 2 ROF scheduled, canceled or missed Owner: Reception / Enrollment / Doctor Purpose: Keep findings report prepared and recover cancellations/no-shows. **preconditions** [] **steps** [ { "action": "Confirm named patient/companion, date/time, early arrival and written questions.", "owner": "Reception / Enrollment / Doctor", "timing": "Before report", "basis": "book", "sourcePhotos": [ "IMG_0361", "IMG_0367" ] }, { "action": "If spouse unavailable, source reschedules to include decision participant.", "owner": "Reception / Enrollment / Doctor", "timing": "At confirmation", "basis": "book", "sourcePhotos": [ "IMG_0361", "IMG_0367" ] }, { "action": "On missed report call welfare check and offer morning/afternoon reschedule.", "owner": "Reception / Enrollment / Doctor", "timing": "When missed", "basis": "book", "sourcePhotos": [ "IMG_0361", "IMG_0367" ] } ] **branches** [ { "condition": "Clinician documented time-sensitive finding", "action": "Use clinician-approved truthful concern message and urgency.", "owner": "Reception", "timing": "At contact", "nextState": "Prompt clinician follow-up", "basis": "inferred", "sourcePhotos": [ "IMG_0361", "IMG_0367" ] }, { "condition": "No documented concern", "action": "Use neutral findings-ready wording; do not manufacture x-ray alarm.", "owner": "Reception", "timing": "At contact", "nextState": "Report reschedule", "basis": "inferred", "sourcePhotos": [ "IMG_0361", "IMG_0367" ] } ] **completion** "ROF attended/rescheduled or refusal/QC handoff recorded with appropriate clinician review." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-early-stage-calls" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "ROF booked", "Prepared", "Confirmed", "Missed", "Contacted", "Rescheduled", "Declined", "Clinician review" ] **gaps** [ "Source urgency wording assumes concerning x-ray finding; no medical urgency thresholds defined." ] **clinicalBoundary** "Clinician-confirmed findings only. Companion attendance must respect patient choice/privacy and not delay urgent results." ### grow-day3-missed · Missed Day 3 onboarding recovery Sources: IMG_0361, IMG_0367 Trigger: Day 3 missed Owner: Enrollment / Reception Purpose: Find and solve the actual blocker after care/finance discussion. **preconditions** [] **steps** [ { "action": "Use judgment on Day 3 reminder; source normally no confirmation call.", "owner": "Enrollment / Reception", "timing": "Before Day 3 if needed", "basis": "book", "sourcePhotos": [ "IMG_0361", "IMG_0367" ] }, { "action": "Call missed-visit check-in and ask how things are going.", "owner": "Enrollment / Reception", "timing": "When missed", "basis": "book", "sourcePhotos": [ "IMG_0361", "IMG_0367" ] }, { "action": "Explore actual reason, including finances or absent decision participant, and arrange in-person financial resolution where appropriate.", "owner": "Enrollment / Reception", "timing": "During recovery", "basis": "book", "sourcePhotos": [ "IMG_0361", "IMG_0367" ] }, { "action": "Route unresolved issues to Room 4 or QC.", "owner": "Enrollment / Reception", "timing": "After discovery", "basis": "book", "sourcePhotos": [ "IMG_0361", "IMG_0367" ] } ] **branches** [] **completion** "Day 3 completion rescheduled or barrier/decline/QC outcome documented." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-early-stage-calls" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Expected", "Missed", "Contacted", "Barrier found", "Room 4", "Rescheduled", "Declined", "QC" ] **gaps** [ "No retry cadence; finances are an author hypothesis, not an automatic label." ] **clinicalBoundary** "Historical fees, discounts, free services and donation offers are source examples, not approved current terms. Review actual pricing, eligibility, payer rules and consent before use; no automatic charging or pressure for financial disclosure. Respect informed choice; no forced recommitment." ### grow-regular-missed · Twenty-minute missed-care appointment rescue Sources: IMG_0363, IMG_0364, IMG_0365, IMG_0394 Trigger: Regular appointment time passes without arrival Owner: Reception Purpose: Catch missed appointments promptly and preserve make-up and barrier-resolution work. **preconditions** [] **steps** [ { "action": "Call within 20 minutes: ask whether en route.", "owner": "Reception", "timing": "Within 20 minutes", "basis": "book", "sourcePhotos": [ "IMG_0363", "IMG_0364", "IMG_0365" ] }, { "action": "If en route obtain ETA and note expected arrival.", "owner": "Reception", "timing": "At answer", "basis": "book", "sourcePhotos": [ "IMG_0363", "IMG_0364", "IMG_0365" ] }, { "action": "If not coming, identify concern and attempt today/tomorrow reschedule.", "owner": "Reception", "timing": "At answer", "basis": "book", "sourcePhotos": [ "IMG_0363", "IMG_0364", "IMG_0365" ] }, { "action": "For corrective care arrange MUD at next visit; commitment source requires make-up within 7 days.", "owner": "Reception", "timing": "Next encounter;7 day deadline cross-reference IMG 0394", "basis": "book", "sourcePhotos": [ "IMG_0363", "IMG_0364", "IMG_0365", "IMG_0394" ] }, { "action": "For barrier suggest one visit and notify Room 4 owner for arrival.", "owner": "Reception", "timing": "During contact", "basis": "book", "sourcePhotos": [ "IMG_0363", "IMG_0364", "IMG_0365" ] }, { "action": "Record all communication.", "owner": "Reception", "timing": "After each contact", "basis": "book", "sourcePhotos": [ "IMG_0363", "IMG_0364", "IMG_0365" ] } ] **branches** [ { "condition": "Unreachable", "action": "End-of-shift source voicemail proposes 5:30 same day; use tentative status until accepted.", "owner": "Reception", "timing": "End of missed shift", "nextState": "Tentative rescue", "basis": "book", "sourcePhotos": [ "IMG_0363", "IMG_0364", "IMG_0365" ] }, { "condition": "Feels better and refuses routine visit", "action": "Offer possible release exam with doctor.", "owner": "Reception", "timing": "During call", "nextState": "Release-exam offered", "basis": "book", "sourcePhotos": [ "IMG_0363", "IMG_0364", "IMG_0365" ] }, { "condition": "Several consecutive missed", "action": "Discover/resolve; if refuses to reschedule tell doctor.", "owner": "Reception", "timing": "Repeated misses", "nextState": "Doctor review", "basis": "book", "sourcePhotos": [ "IMG_0363", "IMG_0364", "IMG_0365" ] }, { "condition": "Sick, injured or worse", "action": "Clinical triage decides whether/how to attend; do not blindly apply source “all the more reason.”", "owner": "Reception", "timing": "Immediately", "nextState": "Clinical review", "basis": "inferred", "sourcePhotos": [ "IMG_0363", "IMG_0364", "IMG_0365" ] } ] **completion** "Arrived or accepted replacement/MUD, declined/release-exam plan, or explicit doctor/QC handoff." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-missed-care", "grow-repeated-missed" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." }, { "action": "Due 20 minute human-call task, end-of-shift unresolved list, linked MUD with 7 day due and Room 4 arrival flag.", "basis": "inferred", "rationale": "Makes the printed timing and handoff obligations persistent." } ] **states** [ "Expected", "Missed 20 min", "Calling", "En route", "Rescheduled", "MUD due", "Room 4 flagged", "Release review", "Doctor review", "Closed" ] **gaps** [ "Definition of several misses and repeated-contact policy absent.", "5:30 arbitrary source slot cannot override actual availability or confirmed consent." ] **clinicalBoundary** "Symptom deterioration and emergencies route to clinical judgment. Do not assume identity on answer or reveal health details before verification." ### grow-inactive-checkin · Long-inactive patient check-in Sources: IMG_0364, IMG_0365 Trigger: Patient absent for a long time Owner: CA / Reception on doctor behalf Purpose: Distinguish well, unresolved symptoms and office dissatisfaction; close or ask permission for future contact. **preconditions** [] **steps** [ { "action": "Call doctor-requested check-in and review previous symptoms.", "owner": "CA / Reception on doctor behalf", "timing": "Long absence; interval unspecified", "basis": "book", "sourcePhotos": [ "IMG_0364", "IMG_0365" ] }, { "action": "Ask whether office helped and current status.", "owner": "CA / Reception on doctor behalf", "timing": "During call", "basis": "book", "sourcePhotos": [ "IMG_0364", "IMG_0365" ] }, { "action": "If well/helped, offer maintenance check; if declines ask permission for later follow-up and optional referral.", "owner": "CA / Reception on doctor behalf", "timing": "Same call", "basis": "book", "sourcePhotos": [ "IMG_0364", "IMG_0365" ] } ] **branches** [ { "condition": "Not helped or office upset", "action": "Try to resolve, arrange doctor visit to make matters right.", "owner": "CA / Reception on doctor behalf", "timing": "During call", "nextState": "Service recovery", "basis": "book", "sourcePhotos": [ "IMG_0364", "IMG_0365" ] }, { "condition": "Not well/new recurrence", "action": "Ask what is happening and arrange clinician assessment.", "owner": "CA / Reception on doctor behalf", "timing": "During call", "nextState": "Doctor visit offered", "basis": "book", "sourcePhotos": [ "IMG_0364", "IMG_0365" ] }, { "condition": "Well and declines appointment", "action": "Record future-contact permission or refusal; no invented cadence.", "owner": "CA / Reception on doctor behalf", "timing": "During call", "nextState": "Permission recorded", "basis": "book", "sourcePhotos": [ "IMG_0364", "IMG_0365" ] } ] **completion** "Current status, patient preference and accepted booking or closure recorded." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-inactive-call" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Inactive", "Contact attempted", "Well", "Concern", "Office upset", "Booked", "Permission follow-up", "Declined" ] **gaps** [ "Long-time threshold and future interval undefined on this page." ] **clinicalBoundary** "Maintenance recommendations and symptomatic assessment require licensed judgment." ### grow-qc-exit · Quality-control handoff and exit-form routing Sources: IMG_0368 Trigger: Recovery unsuccessful or move/death/other permanent exit learned Owner: Recovery owner → Quality control Purpose: Prevent unresolved recovery cases and permanent exits from remaining in ordinary contact sequences. **preconditions** [] **steps** [ { "action": "Make notes and send unresolved case to quality control for decision.", "owner": "Recovery owner → Quality control", "timing": "After unable to restore/resolve", "basis": "book", "sourcePhotos": [ "IMG_0368" ] }, { "action": "Initiate EXIT FORM on move/death or other appropriate reason.", "owner": "Recovery owner → Quality control", "timing": "When learned", "basis": "book", "sourcePhotos": [ "IMG_0368" ] } ] **branches** [] **completion** "QC acknowledgment/decision or completed exit routing; suppression is inferred." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." }, { "action": "Explicit QC owner acceptance, unresolved exception queue and sequenced outreach cancellation on recorded exit.", "basis": "inferred", "rationale": "Book names a handoff/form but digital queues ensure it cannot silently disappear." } ] **states** [ "Unresolved", "QC handoff", "QC accepted", "Decision", "Exit form open", "Exited" ] **gaps** [ "EXIT FORM fields, QC decision tree and timing not included here." ] **clinicalBoundary** "Accurate death/move status verification and private records access required; no public patient information." ### grow-low-volume · Low Day 1 volume recovery campaign Sources: IMG_0369 Trigger: Day 1 count insufficient to sustain source “normal graph” Owner: Reception / Marketing / Enrollment Purpose: Deploy source-ordered existing lead pools when new-patient production drops. **preconditions** [] **steps** [ { "action": "Reconcile missed Day 1 names/numbers daily from appointment book into recovery pool and use Primary Script.", "owner": "Reception / Marketing / Enrollment", "timing": "Daily", "basis": "book", "sourcePhotos": [ "IMG_0369" ] }, { "action": "Call missed Day 2/3 then survey/PGC/referral/massage leads.", "owner": "Reception / Marketing / Enrollment", "timing": "During recovery campaign", "basis": "book", "sourcePhotos": [ "IMG_0369" ] }, { "action": "Ask active patients for referrals and employer/club/church introductions.", "owner": "Reception / Marketing / Enrollment", "timing": "During visits", "basis": "book", "sourcePhotos": [ "IMG_0369" ] }, { "action": "Distribute PGCs/surveys and book evaluations.", "owner": "Reception / Marketing / Enrollment", "timing": "Outreach blocks", "basis": "book", "sourcePhotos": [ "IMG_0369" ] } ] **branches** [] **completion** "Every selected lead has owner/outcome and dashboard returns to reviewed volume target or escalation." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Volume below target", "Lead pools reviewed", "Owners assigned", "Calling", "Outreach", "Results reviewed" ] **gaps** [ "Normal graph threshold not defined;20–25 weekly marketing target elsewhere does not automatically define alert threshold." ] **clinicalBoundary** "No duplicate simultaneous sequences across Reception/Marketing/Enrollment; proposed single-case ownership and shared activity history." ### grow-inactive-return · Returning inactive patient intake and recommitment Sources: IMG_0369, IMG_0370 Trigger: Patient returns after usually 1 month+ or substantial absence Owner: Reception → CA / Enrollment → Doctor Purpose: Avoid routine check-in bypass when health, paperwork, calendar or financial situation may have changed. **preconditions** [] **steps** [ { "action": "Reception seats patient and gives travel card to CA, not patient.", "owner": "Reception → CA / Enrollment → Doctor", "timing": "Check-in", "basis": "book", "sourcePhotos": [ "IMG_0369", "IMG_0370" ] }, { "action": "Pull prior films, including storage if needed; escort to consult room.", "owner": "Reception → CA / Enrollment → Doctor", "timing": "Before adjustment", "basis": "book", "sourcePhotos": [ "IMG_0369", "IMG_0370" ] }, { "action": "Ask new injury and handle updates, education, calendar and financial issues.", "owner": "Reception → CA / Enrollment → Doctor", "timing": "Consultation", "basis": "book", "sourcePhotos": [ "IMG_0369", "IMG_0370" ] }, { "action": "For long absence update all paperwork and use new-patient consultation.", "owner": "Reception → CA / Enrollment → Doctor", "timing": "As indicated", "basis": "book", "sourcePhotos": [ "IMG_0369", "IMG_0370" ] }, { "action": "If resolved, prepare for clinician adjustment; if beyond ability brief doctor privately and accompany for instructions.", "owner": "Reception → CA / Enrollment → Doctor", "timing": "Before treatment", "basis": "book", "sourcePhotos": [ "IMG_0369", "IMG_0370" ] } ] **branches** [] **completion** "Updates/concerns assessed, clinician clearance/plan and documented handoff." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Return flagged", "CA routed", "Records prepared", "Consultation", "Doctor handoff", "Ready for care", "Follow-up needed" ] **gaps** [ "“Long time” requiring full new-patient processing undefined.", "Seven-year film retention is historical source policy, not a verified current legal requirement." ] **clinicalBoundary** "New injury, diagnosis and adjustment readiness require clinician decision." ### grow-room4 · Private Room 4 barrier-resolution workflow Sources: IMG_0371, IMG_0395, IMG_0397, IMG_0398 Trigger: Missed appointments, financial/calendar concern, dropout signal or receptionist detects issue Owner: Reception → Enrollment / CA → Doctor when needed Purpose: Route concerns privately, investigate actual barriers and leave a documented resolution or scheduled next step. **preconditions** [] **steps** [ { "action": "Reception moves patient to private consult/x-ray room, routes card and alerts enrollment; pull films.", "owner": "Reception → Enrollment / CA → Doctor when needed", "timing": "When issue detected", "basis": "book", "sourcePhotos": [ "IMG_0371", "IMG_0395", "IMG_0397", "IMG_0398" ] }, { "action": "With time audit financials, recommendations vs adherence, notes/card and films; without time inspect essentials.", "owner": "Reception → Enrollment / CA → Doctor when needed", "timing": "Before conversation", "basis": "book", "sourcePhotos": [ "IMG_0371", "IMG_0395", "IMG_0397", "IMG_0398" ] }, { "action": "Show concern; ask actual issue and any additional barriers, resolve within role.", "owner": "Reception → Enrollment / CA → Doctor when needed", "timing": "During meeting", "basis": "book", "sourcePhotos": [ "IMG_0371", "IMG_0395", "IMG_0397", "IMG_0398" ] }, { "action": "If information missing, promise to obtain it and set another meeting.", "owner": "Reception → Enrollment / CA → Doctor when needed", "timing": "Before ending", "basis": "book", "sourcePhotos": [ "IMG_0371", "IMG_0395", "IMG_0397", "IMG_0398" ] }, { "action": "Involve doctor when necessary; source may use commitment questions with films.", "owner": "Reception → Enrollment / CA → Doctor when needed", "timing": "If clinical/complex or beyond CA", "basis": "book", "sourcePhotos": [ "IMG_0371", "IMG_0395", "IMG_0397", "IMG_0398" ] } ] **branches** [] **completion** "Issue category, agreed resolution, next appointment/action and owner recorded; no open concern lacks next step." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-room4-question" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." }, { "action": "Arrival flag and acknowledgment handoff to enrollment; carry unresolved follow-up until resolved or explicit patient decline.", "basis": "inferred", "rationale": "Digital equivalent of travel-card routing and private-room ownership." } ] **states** [ "Concern detected", "Private room ready", "Owner notified", "Investigating", "Resolution offered", "Follow-up booked", "Doctor escalation", "Resolved", "Patient declined" ] **gaps** [ "No numeric escalation SLA; “beyond ability” needs role policy." ] **clinicalBoundary** "Financial and clinical autonomy respected; source “excuses” framing is not an automated factual classification." ### grow-visit7 · Seventh-visit progress, retention and referral checkpoint Sources: IMG_0390 Trigger: Seventh attended visit Owner: CA 3 then Doctor for clinical concerns Purpose: Detect mismatched expectations before dropout and capture patient-reported progress. **preconditions** [] **steps** [ { "action": "Take patient privately and review original complaints and perceived improvement.", "owner": "CA 3 then Doctor for clinical concerns", "timing": "Visit 7", "basis": "book", "sourcePhotos": [ "IMG_0390" ] }, { "action": "Record source symptom-code scores across visit note line and communicate to doctor.", "owner": "CA 3 then Doctor for clinical concerns", "timing": "During review", "basis": "book", "sourcePhotos": [ "IMG_0390" ] }, { "action": "Score meaning must be explicit: source HA 5=50% improved, NK 9=10% improved, LB 2=80% improved; these examples encode remaining complaint severity rather than improvement percentage itself.", "owner": "CA 3", "timing": "When recording patient-reported progress", "basis": "book", "sourcePhotos": [ "IMG_0390" ] }, { "action": "Check new symptoms, inadequate relief, doubt after improvement, finances, insurance and understanding; route unresolved issues.", "owner": "CA 3 then Doctor for clinical concerns", "timing": "During review", "basis": "book", "sourcePhotos": [ "IMG_0390" ] }, { "action": "If appropriate obtain testimonial and optional referrals including group-talk contacts; give contacts to doctor and acknowledge attendance.", "owner": "CA 3 then Doctor for clinical concerns", "timing": "After evaluation", "basis": "book", "sourcePhotos": [ "IMG_0390" ] } ] **branches** [] **completion** "Progress and barriers recorded, clinician escalation accepted where needed, optional referral/story outcome captured." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-visit7-referral" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Due", "Interviewed", "Progress recorded", "Concern escalated", "Story/referral offered", "Complete" ] **gaps** [ "Source HA 5/NK 9/LB 2 convention is easy to invert; UI must label remaining severity vs improvement explicitly." ] **clinicalBoundary** "Staff collect reports, not clinical interpretation; new/worsening symptoms require doctor assessment." ### grow-imaging-prep · Imaging marking queue and report readiness Sources: IMG_0391 Trigger: Clinician-ordered imaging completed Owner: Qualified imaging staff / Doctor Purpose: Track films through authorized marking and comparison review before reports. **preconditions** [] **steps** [ { "action": "Put new films in to-be-marked queue.", "owner": "Qualified imaging staff / Doctor", "timing": "After acquisition", "basis": "book", "sourcePhotos": [ "IMG_0391" ] }, { "action": "Perform specified projection markings and Doctor Use Form; record anomalies/pathology for clinician.", "owner": "Qualified imaging staff / Doctor", "timing": "Throughout day and before departure", "basis": "book", "sourcePhotos": [ "IMG_0391" ] }, { "action": "Projection checklist: AP cervical atlas/dominant listings; lateral cervical atlas angle/curve; AP thoracic wedge/Cobb/listings; AP lumbar sacral base versus femur head, femur head versus film, S 2 rotation with difference circled and wedge/listings; lateral lumbar base angle/spondy/retro; additional anomalies/pathology/fractures. Only authorized clinician-approved interpretation.", "owner": "Qualified imaging staff / Doctor", "timing": "Marking/review stage", "basis": "book", "sourcePhotos": [ "IMG_0391" ] }, { "action": "For follow-up selected views, use same original folder and prepare comparison.", "owner": "Qualified imaging staff / Doctor", "timing": "Before re-report", "basis": "book", "sourcePhotos": [ "IMG_0391" ] }, { "action": "If unsure, cannot see change or lack explanation, consult doctor before patient appointment.", "owner": "Qualified imaging staff / Doctor", "timing": "Before report", "basis": "book", "sourcePhotos": [ "IMG_0391" ] } ] **branches** [] **completion** "Authorized reader confirms markings, reviewed findings and report readiness." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Acquired", "To mark", "Marked", "Doctor review", "Ready for report" ] **gaps** [ "Digital imaging integration/authorized roles not defined; title mentions chemistry but no chemistry procedure appears here." ] **clinicalBoundary** "No unlicensed imaging interpretation or automatic exposure. Modern imaging indication, acquisition and interpretation are clinician-controlled; preserve checklist as historical reference." ### grow-day1 · Day 1 consultation → examination → ROF handoff Sources: IMG_0392, IMG_0393 Trigger: New patient arrives for Day 1 Owner: CA / Doctor / Reception Purpose: Capture concerns, perform clinician evaluation and close with an informed next appointment. **preconditions** [] **steps** [ { "action": "Introduce and consult: beliefs, top-two concerns, impacts, prior attempts and exact patient words.", "owner": "CA / Doctor / Reception", "timing": "Day 1 start", "basis": "book", "sourcePhotos": [ "IMG_0392", "IMG_0393" ] }, { "action": "Document red source laundry list with priorities and brief doctor.", "owner": "CA / Doctor / Reception", "timing": "Before exam", "basis": "book", "sourcePhotos": [ "IMG_0392", "IMG_0393" ] }, { "action": "Doctor examines, explains findings, chooses imaging/costs and addresses significant-other participation.", "owner": "CA / Doctor / Reception", "timing": "Clinical portion", "basis": "book", "sourcePhotos": [ "IMG_0392", "IMG_0393" ] }, { "action": "Record findings, films, charges, companion; perform ordered services.", "owner": "CA / Doctor / Reception", "timing": "After exam", "basis": "book", "sourcePhotos": [ "IMG_0392", "IMG_0393" ] }, { "action": "Book ROF, explain approximately 1 hour agenda, participant logistics and answer questions.", "owner": "CA / Doctor / Reception", "timing": "Before departure", "basis": "book", "sourcePhotos": [ "IMG_0392", "IMG_0393" ] }, { "action": "State itemized/total fees then any approved waiver; collect authorized payment.", "owner": "CA / Doctor / Reception", "timing": "Before departure", "basis": "book", "sourcePhotos": [ "IMG_0392", "IMG_0393" ] } ] **branches** [] **completion** "Consult/exam documented, charges clear and accepted ROF or explicit decision recorded." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-day1-consult", "grow-day1-doctor", "grow-rof-invitation", "grow-day1-fees" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Arrived", "Consulted", "Doctor exam", "Imaging decision", "Services complete", "ROF booked", "Payment recorded", "Done" ] **gaps** [ "Historical amount examples not current; source x-ray diagnostic certainty unsupported." ] **clinicalBoundary** "Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation. Historical fees, discounts, free services and donation offers are source examples, not approved current terms. Review actual pricing, eligibility, payer rules and consent before use; no automatic charging or pressure for financial disclosure." ### grow-day2 · Day 2 prepared report and informed care commitment Sources: IMG_0394, IMG_0395 Trigger: Day 2 ROF booked or unscheduled report file exists Owner: Enrollment / Doctor Purpose: Prepare report materials, discuss actual barriers and offer staged participation where full plan not accepted. **preconditions** [] **steps** [ { "action": "Verify insurance, prepare marked films, Doctor Use Form, care/financial forms and place in scheduled/not-scheduled queue.", "owner": "Enrollment / Doctor", "timing": "Before ROF", "basis": "book", "sourcePhotos": [ "IMG_0394", "IMG_0395" ] }, { "action": "Discuss findings, care responsibilities, on-time visits, missed-visit make-up within 7 days, home rehab and education.", "owner": "Enrollment / Doctor", "timing": "Report meeting", "basis": "book", "sourcePhotos": [ "IMG_0394", "IMG_0395" ] }, { "action": "Ask readiness/commitment and obstacles; answer concerns; if full program not accepted, discuss stage through first re-exam.", "owner": "Enrollment / Doctor", "timing": "Before finances", "basis": "book", "sourcePhotos": [ "IMG_0394", "IMG_0395" ] }, { "action": "Always ask other obstacles even if enthusiastic; ask ready-to-start, then approved financial workflow.", "owner": "Enrollment / Doctor", "timing": "Before decision", "basis": "book", "sourcePhotos": [ "IMG_0394", "IMG_0395" ] } ] **branches** [] **completion** "Report delivered, understanding/decision and agreed care stage documented; finances handed off." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-day2-commitment" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Report not scheduled", "Preparing", "Ready", "Report delivered", "Questions", "Full plan", "Staged plan", "Deferred", "Financial discussion" ] **gaps** [ "No clinical plan formulation rules here; source insists happy 10, which cannot be enforced automatically." ] **clinicalBoundary** "Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation. Record authentic voluntary readiness; do not repeatedly pressure until a forced 10." ### grow-day3 · Day 3 enrollment completion gate Sources: IMG_0396 Trigger: Day 3 appointment or unfinished enrollment tasks Owner: Enrollment / CA Purpose: Finish every onboarding obligation so the active-care handoff is complete. **preconditions** [] **steps** [ { "action": "Verify signed paperwork, accepted financial terms/payment setup and demonstrated prescribed rehab.", "owner": "Enrollment / CA", "timing": "Day 3", "basis": "book", "sourcePhotos": [ "IMG_0396" ] }, { "action": "Offer/schedule family evaluation as voluntarily accepted.", "owner": "Enrollment / CA", "timing": "Day 3", "basis": "book", "sourcePhotos": [ "IMG_0396" ] }, { "action": "Complete new-patient checklist/log, important computer notes and travel-card markings.", "owner": "Enrollment / CA", "timing": "Before closing Day 3", "basis": "book", "sourcePhotos": [ "IMG_0396" ] }, { "action": "Confirm understanding of plan, appointments and exercises; route any unresolved issue.", "owner": "Enrollment / CA", "timing": "Before handoff", "basis": "book", "sourcePhotos": [ "IMG_0396" ] } ] **branches** [] **completion** "Every source checklist item completed, explicitly declined/not applicable or owned unresolved task." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." }, { "action": "Checklist gate with evidence fields; active-care handoff shows unfinished items with owner rather than silently marking complete.", "basis": "inferred", "rationale": "Source says all listed items are completed by Day 3." } ] **states** [ "Day 3 due", "Checklist in progress", "Unresolved tasks", "Complete", "Active care" ] **gaps** [ "Exact new-patient checklist/log forms elsewhere must be linked." ] **clinicalBoundary** "Consent/referrals must remain voluntary; completion status must accurately capture declined components." ### grow-reexam · Twelve-visit and triggered re-exam Sources: IMG_0399, IMG_0401 Trigger: Every 12 attended visits or clinician identifies disengagement/need for earlier review Owner: Doctor or appropriately authorized CA Purpose: Ensure scheduled progress review and earlier concern-triggered review are assigned and documented. **preconditions** [] **steps** [ { "action": "Pull films before shift; at first re-exam obtain Initial Progress Report before adjustment and attach to record.", "owner": "Doctor or appropriately authorized CA", "timing": "Before appointment/adjustment", "basis": "book", "sourcePhotos": [ "IMG_0399", "IMG_0401" ] }, { "action": "After adjustment escort to exam room; doctor covers if enrollment unavailable.", "owner": "Doctor or appropriately authorized CA", "timing": "At review visit", "basis": "book", "sourcePhotos": [ "IMG_0399", "IMG_0401" ] }, { "action": "Review report issues before patient leaves; repeat indicated positive tests, assess progress and discuss source four questions.", "owner": "Doctor or appropriately authorized CA", "timing": "During review", "basis": "book", "sourcePhotos": [ "IMG_0399", "IMG_0401" ] }, { "action": "Review exercises/heel lift/attendance and barriers; improving patients may be offered testimonial/referral.", "owner": "Doctor or appropriately authorized CA", "timing": "During review", "basis": "book", "sourcePhotos": [ "IMG_0399", "IMG_0401" ] }, { "action": "Record exam marker#2 and circledRE per source, then front-desk next appointment.", "owner": "Doctor or appropriately authorized CA", "timing": "Before departure", "basis": "book", "sourcePhotos": [ "IMG_0399", "IMG_0401" ] } ] **branches** [ { "condition": "Not improving or new concern", "action": "Doctor makes recommendations rather than treating as ordinary referral opportunity.", "owner": "Doctor or appropriately authorized CA", "timing": "During review", "nextState": "Clinical plan review", "basis": "book", "sourcePhotos": [ "IMG_0399", "IMG_0401" ] }, { "condition": "Enrollment unavailable", "action": "Doctor performs re-exam.", "owner": "Doctor or appropriately authorized CA", "timing": "At appointment", "nextState": "Doctor coverage", "basis": "book", "sourcePhotos": [ "IMG_0399", "IMG_0401" ] } ] **completion** "Progress review completed with issues addressed/owned, clinical plan and next visit recorded." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-reexam-questions" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Review due", "Prepared", "Progress form complete", "Exam", "Plan reviewed", "Card updated", "Next visit" ] **gaps** [ "What constitutes authorized CA clinical testing requires scope decision.", "Earlier discretionary review trigger is not an automatic noncompliance diagnosis." ] **clinicalBoundary** "Clinical assessment/testing and changes only by authorized staff. Source organ-damage assertions and enforced 10 need review." ### grow-rereport · Follow-up imaging review and re-report branches Sources: IMG_0391, IMG_0399, IMG_0400, IMG_0401 Trigger: Clinician chooses follow-up assessment, source often 24–36 visits/2–3 months Owner: Doctor / Authorized imaging staff / Reception Purpose: Carry clinician-ordered follow-up imaging to comparative review and close error/worsening exceptions. **preconditions** [] **steps** [ { "action": "Clinician determines indicated films and records order/RE 3 marker.", "owner": "Doctor / Authorized imaging staff / Reception", "timing": "At selected review", "basis": "book", "sourcePhotos": [ "IMG_0391", "IMG_0399", "IMG_0400", "IMG_0401" ] }, { "action": "Acquire authorized views, store with prior images, mark and compare; repeat indicated tests.", "owner": "Doctor / Authorized imaging staff / Reception", "timing": "Before re-report", "basis": "book", "sourcePhotos": [ "IMG_0391", "IMG_0399", "IMG_0400", "IMG_0401" ] }, { "action": "Reception schedules RR after imaging.", "owner": "Doctor / Authorized imaging staff / Reception", "timing": "Before patient departure", "basis": "book", "sourcePhotos": [ "IMG_0391", "IMG_0399", "IMG_0400", "IMG_0401" ] }, { "action": "Present clinician-confirmed comparison and approved care schedule.", "owner": "Doctor / Authorized imaging staff / Reception", "timing": "At RR", "basis": "book", "sourcePhotos": [ "IMG_0391", "IMG_0399", "IMG_0400", "IMG_0401" ] } ] **branches** [ { "condition": "Improved", "action": "Compare first and follow-up films; doctor quantifies legitimate change and explains schedule.", "owner": "Doctor / Authorized imaging staff / Reception", "timing": "At RR", "nextState": "Updated plan", "basis": "book", "sourcePhotos": [ "IMG_0391", "IMG_0399", "IMG_0400", "IMG_0401" ] }, { "condition": "Worse or unclear", "action": "Verify marks and positioning; consult doctor before patient report.", "owner": "Doctor / Authorized imaging staff / Reception", "timing": "Before RR", "nextState": "Technical/clinical review", "basis": "book", "sourcePhotos": [ "IMG_0391", "IMG_0399", "IMG_0400", "IMG_0401" ] }, { "condition": "Technical error", "action": "Remark if appropriate; clinician alone decides whether retake justified; source defers RR to next visit.", "owner": "Doctor / Authorized imaging staff / Reception", "timing": "After review", "nextState": "Corrected report pending", "basis": "book", "sourcePhotos": [ "IMG_0391", "IMG_0399", "IMG_0400", "IMG_0401" ] }, { "condition": "Technically accurate worsening", "action": "Clinician assesses actual deterioration and rehab; never auto-attribute to expected early worsening.", "owner": "Doctor", "timing": "Prompt review", "nextState": "Clinical escalation", "basis": "inferred", "sourcePhotos": [ "IMG_0391", "IMG_0399", "IMG_0400", "IMG_0401" ] } ] **completion** "RR performed or correction/escalation has owner and date; revised plan communicated." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-rereport-improved" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." } ] **states** [ "Follow-up considered", "Ordered", "Acquired", "Marked", "RR scheduled", "Improved", "Error review", "Worsening review", "Report complete" ] **gaps** [ "24–36 visit range conflicts with before 35th visit instruction; unresolved owner/clinician decision.", "Yearly film example for monthly patients is historical, not an automatic imaging requirement." ] **clinicalBoundary** "Radiation exposure requires clinical necessity. Source normalizes early worsening and implies homework fault; do not automate those conclusions." ### grow-travel-card · Travel-card continuity, billing evidence and next visit Sources: IMG_0402 Trigger: First adjustment, technique change, imaging/exam or visit completion Owner: Doctor / CA / Reception / Billing Purpose: Preserve technique/response, completed services and next appointment across care records. **preconditions** [] **steps** [ { "action": "Record technique and procedure baseline on first adjustment.", "owner": "Doctor / CA / Reception / Billing", "timing": "First adjustment", "basis": "book", "sourcePhotos": [ "IMG_0402" ] }, { "action": "Clinician reviews response and retains/changes technique as appropriate.", "owner": "Doctor / CA / Reception / Billing", "timing": "Following visits", "basis": "book", "sourcePhotos": [ "IMG_0402" ] }, { "action": "Circle established useful notes to transfer to subsequent cards.", "owner": "Doctor / CA / Reception / Billing", "timing": "When established", "basis": "book", "sourcePhotos": [ "IMG_0402" ] }, { "action": "Mark exams/x-rays in correct sections for billing.", "owner": "Doctor / CA / Reception / Billing", "timing": "When services actually performed", "basis": "book", "sourcePhotos": [ "IMG_0402" ] }, { "action": "Check calendar and remind next appointment.", "owner": "Doctor / CA / Reception / Billing", "timing": "Before departure", "basis": "book", "sourcePhotos": [ "IMG_0402" ] } ] **branches** [] **completion** "Accurate service/clinical notes carried forward and next appointment communicated." **stopConditions** [ "Proposed safeguard: respect explicit refusal, contact restrictions and recorded consent; route exceptional cases to an accountable human." ] **escalation** [] **scriptIds** [ "grow-next-visit" ] **proposedAutomation** [ { "action": "Create an assigned task with source-page and approved-script links, due time, outcome capture and an auditable completion record.", "basis": "inferred", "rationale": "Digital orchestration of the book’s named duty; the book itself uses paper/cards/people." }, { "action": "Structured longitudinal record with carried-forward notes and service evidence linked to billing, not autonomous billing.", "basis": "inferred", "rationale": "Digitizes source travel-card marks and continuity." } ] **states** [ "Visit open", "Technique recorded", "Response reviewed", "Services marked", "Next visit checked", "Closed" ] **gaps** [ "72 hour impression/twice-daily statement is not a clinical escalation protocol." ] **clinicalBoundary** "Treatment frequency, force and technique require clinician judgment; financial/billing claims require actual rendered-service evidence." ## Exact source scripts ### rec-phone-greeting · Answering, message-taking and two-choice appointment script Sources: IMG_0245 **Answering a call:** - “Hello it's another great day at ~~Willow Creek~~ Chiropractic, this is ______, I can help you.” **Taking a message:** - Whom may I say is calling? - And what is this regarding? - With this information you can now decide what to do with the message. **Making an appointment:** - Is morning or afternoon better? - I have ______ or ______, which works best for you? (The next 2 mornings or next 2 afternoons) - I have ______ or ______, which works best for you? (Choose 2 times in the AM or PM) Notes: Exact source wording is retained as archival reference; names, fees and scheduling examples are historical placeholders. ### rec-inbound-questions · Inbound questions and appointment close Sources: IMG_0235, IMG_0246 **A call wants to make an appointment:** - When was the last time you saw the doctor? - This now allows you to determine if it is a new patient or an existing patient. **It's a New Patient:** - Get name and phone number. - How did you hear about our office? - Is this appointment for you or your entire family? - Make the appointment. - Give directions. **It's an existing patient:** - Make the appointment (Is morning or afternoon better.......) **The person calling has questions:** - Questions mean they are shopping and the way to handle this is to answer their question, and then without hesitation go right into the close which is to schedule the appointment. **Examples:** Do you accept insurance? Yes, we take all insurances, bring it with you when you come, is morning or afternoon better? Do you adjust children? Yes, we take care of all ages, is morning or afternoon better? Do you have later hours? Yes, we do is morning or afternoon better for you? How much is an adjustment? There is no charge to meet with the doctor, is morning or afternoon better for you? But how much is an adjustment? Like I said there is no charge to meet with the doctor and if he can help you then he will go over any fees with you, is morning or afternoon better for you. But I just want to know how much an adjustment is? What are you used to paying? We can work with that, is morning or afternoon best? (never say our fees over the phone) Notes: The annotated duplicate IMG_0246 strikes out the first free-doctor-consultation phrase and adds “Initial Consult.” Broad insurance acceptance, fee evasion and implied price matching require current office-policy review; never send these assertions automatically. ### rec-calendar-clarify · Confirm a doctor-provided calendar Sources: IMG_0244 ok, it looks like the doctor need to see you 2x a week, what 2 days work best for you? Notes: Exact source wording is retained as archival reference; names, fees and scheduling examples are historical placeholders. ### rec-missed-visit-message · Missed visit: proposed evening make-up message Sources: IMG_0241 John we missed you this morning for your appointment, something must have come up. I am going to put you down for tonight at 5:30. Let me know if there is a better time. See you tonight at 5:30. Notes: Historical assumed-booking wording. Proposed implementation must distinguish offered make-up slots from patient-confirmed appointments. Do not infer consent or attendance from a message. ### rec-missed-visit-20min · Missed visit: twenty-minute call Sources: IMG_0248 1. Call within 20 minutes of a missed appointment, and leave a message like “_____ this is _____ from ~~Willow Creek~~ Chiropractic. We had you scheduled at _____ for your appointment. → Hopefully you are on your way. If you don’t make it by 11 then I will assume you are coming in this afternoon. Notes: Original source markup retained. Image inspected: handwritten change to step 2 says “re Schedule them”; first message wording is clearly legible. No automated emergency-contact or blocked-number outreach. ### rec-day1-reminder · Day 1 reminder call Sources: IMG_0247 **Day 1 reminder call:** - “Hello _____ this is _____ from ~~Willow Creek~~ [handwritten: SCHRAEDEL] Chiropractic. We have you scheduled for _____ and was wondering if you needed any directions? - If they remembered the appointment give them directions if they need it and let them know we are excited to meet them. - If they forgot then reschedule it, but find out what health problem they want fixed and reassure them that they are coming to the right place. Notes: Exact source wording is retained as archival reference; names, fees and scheduling examples are historical placeholders. ### rec-day2-reminder · Day 2 reminder call Sources: IMG_0247 **Day 2 reminder call:** - “Hello _____ this is _____ from ~~Willow Creek~~ [handwritten: schraedel] Chiropractic. We have you and your wife scheduled for _____ and the doctor wanted me to remind you that write down any questions you have and we will be sure to address all of them. - If they remembered the appointment or not you will now know and can handle any rescheduling issues and can reaffirm that they are in the right place, and the doctor found what was causing their problem. Notes: Original assurance that the doctor found the cause must only be used when a clinician has actually established and approved that statement. ### rec-recontact-branches · Once contact is restored: four conversation branches Sources: IMG_0249 They will usually fall in one of the following categories: **They feel good and that is why they quit coming.** In this case let them know we are glad they are feeling better, however we have not finished the correction of the spine that caused it. Let them know there is a difference between just feeling better and actually correcting the problem. Try to schedule a special consultation with the doctor. If they won't then find out if they just want to go with relief care or correct it. If they want just relief care then try to schedule them monthly to keep it that way. If they won't do that then ask them, “When your pain returns, would you feel comfortable coming back into the office? If they would then we did well and they just want relief care. If they wouldn't then something went wrong so find out what it was so we can improve. **The don't feel the treatment is working.** In this case set up a special consultation with the doctor to re-evaluate their case and see if he needs to change something or refer the patient to someone who can get results. **Money has become a problem.** In this case, get them in to meet with Enrollment. The patient is always more important than money. We will work out something. **They want to discontinue care, and don’t give a reason that makes sense.** In this case ask them for their feedback on how we can improve. If they still don’t tell, then ask if we have offended them in any way? You can’t hurt our feelings; we want you to be honest so we can improve. (There is a reason they want to divorce us, here you get to find out what it was) Maybe we can fix it maybe we can’t, but we need to know. Notes: Preserve four source branches. Claims about spinal correction and inevitable pain return are historical source language requiring clinician review; a patient may decline further care. ### rec-day1-fee · Day 1 fees and waived-service explanation Sources: IMG_0253 **“Now it looks like the examination is 30 and the x-rays are 120. The total for today’s services is 150. How would you like to take care of that? We take cash, check, or credit card.”** If some of the services are at no charge, then state all the fees. After a short pause tell them what was not charged. **“Now it looks like the examination is 30 and the x-rays are 120. The total for today’s services is 150. (Pause) However, because you came in from our (I. e. drawing, lecture, health fair, etc.) today’s visit is at no charge.”** Notes: Amounts are source examples, not the proposed clinic fee schedule. State accurate approved charges and actual waiver terms. ### rec-rof-reminder-sheet · Report of Findings appointment handout Sources: IMG_0254 ## _Your Report of Findings Appointment_ _Your appointment to find out the results of your examination and x-rays is scheduled on _____________ at _____________ with _______________ Because this is the most important appointment you will ever have in our office, we ask that you allow 1 hour of time without interruptions, to go over your results and answer any questions. Your results, care recommendation, home care instructions, and finances will be discussed. We ask that those individuals that help you make these decisions, be with you during your report. We love to have children in our office, however on this visit we ask that you get a baby sitter so that you do not miss any information that is given. If you are unable to obtain a baby sitter one of our staff will watch your child so that you don't miss any important information. If for some reason you need to reschedule this appointment, call us at 801-942-4999. _Thank you,_ Notes: Original handout preserved. Replace historical office number in any future approved template. Patient chooses support-person involvement; “most important” is source language. ### rec-doctor-cell · First-adjustment doctor contact handoff Sources: IMG_0255 The doctor has asked me to give you his cell number in case you ever have any questions or concerns. Notes: Publish only an approved clinical contact route, never a private number in the proposal. ### rec-referral-thanks · Thank the patient who referred someone Sources: IMG_0257 Thank you so much for referring in _____ we sure appreciate it. It looks like we are going to be able to help them. Notes: Do not disclose another person’s treatment status without permission; rewards require a current policy decision. ### rec-day1-concerns · Day 1 consultation and concern discovery Sources: IMG_0271 “What have you heard about chiropractic? Positive or negative?” (What else have you heard?) “I see you have several health concerns and you listed ____ as your major concern. Tell me about it.” (Find the top 2 concerns) “How does it affect you at work, home, hobbies...?” “How old did you think that people should be when they had these problems?” ........ [The goal is to get them to RUIN on the tone scale. A place mentally that they cannot continue living with their problems] [Write down your laundry list of what they said, especially any quotes they have said. This will be used on Day 2.] Notes: Capture the patient’s own goals and exact quotes. The source’s aim of bringing someone to “RUIN” is archived and flagged, not an acceptable automated persuasion objective. ### rec-day1-education-archive · Day 1 source explanation of subluxation Sources: IMG_0271 “The doctor will be with you in a minute, but before he does, let me explain what he is going to look for. (point to the posters) Your brain controls your entire body through the nervous system. (Yellow nerves chart) These nerves cause pain and go to your head arms and legs. (Organ nerve chart) And these nerves go to all of your organs. Sometimes these bones can get knocked out of place (show this by poster, or model), and when that happens the bone hits these nerves and puts pressure on them, chocking off the mental impulses that need to get to the tissue. Much like if you had a rubber band wrapped around your finger. What would happen if you had a rubber band wrapped around your finger? And then what would happen? And then what? If the bone is hitting a nerve of pain you will get pain. (point to the area on the yellow nerve chart that correlates with their pain, relate it to their pain) If it is hitting a nerve that controls the function of an organ (point and correlate the organ being affected on the Organ chart), then the organ malfunctions and then the organ becomes diseased and dies, just like your finger would. If there is a bone out of place it will cause pain, swelling and spasms. The doctor will be looking for each of these 3 signs. When the bones can’t move properly arthritis or degeneration starts to grow the bones together. Like these. (show models) “If the doctor finds that you have these misalignments or bones out-of-place causing your ____ and ____. Then you are in the right place and he is going to be able to help you. If not then he will find someone who can. Let’s hope he finds something.” Notes: Historical claims connect misalignment to organ disease/death. Retain for review only; do not send automatically or treat as verified clinical education. ### rec-day1-doctor · Doctor Day 1 findings and next-day explanation Sources: IMG_0272 The doctor will introduce himself, do the exam telling the patient what he has found. Then he will say **_“Tonight I am going to spend detailed time going over your exam and x-ray findings, tomorrow we will tell you what we have found. The x-rays will tell me if you have a muscle or ligament problem or if you have a subluxation. If you have a subluxation, it will tell me exactly where it is, how long you have had it and what we need to do to correct it”. _** He will also cover any costs and the importance of the spouse coming to the ROF. Notes: Archive only until clinician reviews claims that x-rays reveal duration, precise cause and correction plan. ### rec-rof-invite-spoken · Spoken ROF invitation and support-person preparation Sources: IMG_0272 ☐ Set the ROF appointment for them and their significant other, either in the x-ray room, or when you bring them back to a consultation room. **“Our first available appointment is (date). Is there any reason you would not be able to attend it?”** ☐ Go over the ROF appointment form with the patient by saying the following: **_“Now ____ the doctor wants to go over your findings with you and ____. (call them or reschedule if necessary to get them both there) Now ____ this appointment will be the most important appointment you will ever have in our office. Here we will cover your results, care plan, finances, and home care instructions. You will also understand how miracles happen in our office. So you don’t miss any information, we ask that you find a baby sitter if you have children, and plan for about an hour. Do you have any questions?”_** Notes: Source asks for the first available ROF with support person, one hour and child-care planning; preserve choice and privacy in implementation. ### rec-commitment · ROF commitment, obstacles and readiness Sources: IMG_0273, IMG_0274 ## ***Roll playing the commitment:*** What do you think will happen if you leave it alone? “Is this something you want to take care of? “Now, before you answer, you need to know that it is going to take a huge commitment on your part. - You need to show up on time. - Should you miss an appointment you’ll be required to make it up within 7 days. - You will be expected to perform some rehabilitation exercises at home. - We have a health care class that you will be required to attend, also we have classes on nutrition, exercise, stress and time management and other topics throughout the year. Attend as many as you can. “In essence, you must become a very compliant patient in order to get the results that you need and want. So on a scale of 1-10, where are you? An 8 Why not a 10? Objection Handle So what are you now? A 9 Why not a 10? Objection Handle So what are you now? A 10 Great. *[ Continue until the patient states he is at a 10. You are not finished until the patient says 10 quickly and looks happy about it. **“Now that’s not a happy 10. What’s with that?”** If you cannot get them to a 10 you may have to shift to the “by stages” approach and simply ask him whether he would prefer to first monitor his own progress before committing to the full program. Then seek a commitment to the first re-exam. (can tie it back to the timeline of care)]* ## Question #2: (The obstacle question) “What is it that might prevent you from starting and staying on your corrective care program, all the way through to completion?” (Even if the patient had an enthusiastic answer to the first question, still ask question #2. He probably has concerns.) Objection **Handle** **“What else would prevent you?”** **Objection** **Handle** **“What else would prevent you?”** ## Question #3: **“So, all ready to get started?”** ***[Now they should be ready to have you explain the financial obligations. Refer to chapter #6 in this manual.]*** Notes: Source repeatedly seeks an enthusiastic 10/10 and offers a first-re-exam stage if not ready. Preserve the branch and archival wording; no automatic pressure loops or dismissal of patient concerns. ### rec-reexam-referral · Re-exam referral permission conversation Sources: IMG_0276 - [ ] Ask for referrals if they are pleased with us. “*I am not sure if you know what our mission is, but we want to help as many people as possible. Who do you know of that has ____?*” or another question that gets the patient thinking specifically of a person instead of the general human race. The more specific question gives you a more specific answer. Get a name and phone number. “*Would you mind if we were to try to help them? What we found works the best is for the doctor to call them personally, but he won’t call them unless he has permission. Would you ask them if it is OK for him to call?*” Notes: The source expressly says the doctor will not call without permission. Track the referred person’s permission before outreach, not just the referrer’s willingness. ### rec-reexam-four-questions · Four re-exam commitment questions Sources: IMG_0276 What do you see? What is it doing to your spinal cord, nerves and organs? What will happen if you were to leave it alone? We have you scheduled _____ times over the next _____. On a scale from 1-10, 10 being the most committed, how committed are you to keeping all of those appointments? Notes: Historical wording; interpretation of imaging and prognosis belongs to a qualified clinician. Preserve patient-reported progress instead of overriding it. ### rec-auto-example-archive · Auto-accident puppy analogy (archival) Sources: IMG_0278 The patient needs to feel as though the impact was significant enough to do damage. Forces to the body can be explained by the following example. “If a puppy was sitting on the headrest of the passenger seat, was the force enough to knock the puppy off? If it was, where would the puppy end up? Your head like the puppy would end up in the back seat, but because it is attached to your neck, your neck is what gets injured. That injury can cause the bones to compress nerves and cause symptoms. If uncorrected, years from now the bones will degenerate and grow together. Do you think it will be easier to correct it now, or after the degeneration?” Notes: Do not deploy this analogy as proof of injury or causation. Clinical findings, patient history and licensed judgment must determine injury assessment. ### rec-private-rof-financial · Private ROF financial decision tree Sources: IMG_0283 # **Private ROF Financial** - **Positive and negative** with spouse or others that weren’t at Day 1. - Go over what they learned about a **subluxation** from Day 1. - **Pamphlets** - **Show x-rays** (now can you see why you’ve had __________?) - **Laundry list** - “Now you mentioned ....... Is this something you want to fix? But before you answer let me tell you what it is going to take. You will need to keep your appointments, we also have classes throughout the year, you will need to attend as many as you can, and you will need to do your exercises that help correct the spine. In otherwords you need to be a compliant patient. On a scale of 1-10, 10 being the most committed, where are you?” - After you get them to a 10 then ask the **second commitment question**, “Is there anything that would prevent you from following through to the end of your care plan?” - **Are you ready to get started?** (if not then discuss what they are thinking about and resolve it) - Go over **Corrective Care Plan**. (so they know what it will take to get them to maintain care) - Go over **Financial Summary**. (so they know the full cost) - **One-time payment.** (exhaust all options, if can’t then go to monthly payments) - **Monthly payments.** (if cant do monthly up to 12 months, then ask question) - Tell me about your finances. - **Question:** “Tell me what’s going on with your finances?” - **If they tell,** write the P&L down and work something out in a modified plan. - **If they don’t tell,** ask the question again, and if they still don’t tell then go to test driving us for 3 visits and after the 3rd visit you will sit down with them and decide where to go from there. - **If nothing is resolved** then say, “Ok, let me see if Dr. Thomas has any other questions.” And go get Dr. Thomas telling him what you know so far before he gets in the room. This gives Dr. Thomas a chance to see what he can do. Notes: Entire coherent checklist preserved. Source has a different branch ordering than IMG_0267: disclosure leads to modified plan; nondisclosure leads to a three-visit trial. Financial privacy and voluntary decisions must be respected. ### rec-patient-policies · Patient policies form (historical) Sources: IMG_0284 Willow Creek ~~Chiropractic~~ [handwritten X through “Chiropractic”] # Patient Policies ## PAYMENT POLICIES: 1. 20% bookkeeping savings for a one-time payment only. 2. In-house financing requires a credit card to be on file for monthly payments or post-dated checks to be on file. No interest will be applied until after 12 months on any balance. After 12 months the interest is 15%. I also agree to pay on past-due amounts collection fees of up to 40% of the principal owing (U.C.A. sec. 12-1-11), court costs, and attorney fees.. ## REHABILITATION EXERCISES: 1. I understand that the doctor may give me rehabilitation exercises to strengthen and stabilize my spine. These exercises are to be done two times a day for a minimum of 15 minutes each time. ## IN OFFICE WORKSHOPS: 1. Because ~~Willow Creek Chiropractic~~ emphasizes a MAXIMIZED LIVING approach to health and wellness. Monthly we hold workshops on topics such as NUTRITION, EXERCISE, STRESS, TIME MANAGEMENT, VACCINES, INFANT HEALTH AND OTHER TOPICS throughout the year. I understand that it is my responsibility to take advantage of as many workshops as possible by attending them. ## INSURANCE: 1. Most insurance companies do not cover 100% of all medical expenses. I understand that it is my responsibility to pay whatever the insurance does not cover. (Co-payments, deductable, unpaid balances) 2. It is my responsibility to notify Willow Creek Chiropractic of any changes in insurance coverage. 3. Automobile accidents and Work related accidents are covered by separate insurance companies, so I agree to notify ~~Willow Creek Chiropractic~~ if either of these occur. ## DISCONTINUATION OF CARE: 1. In the event you choose to discontinue care for any reason, or we regretfully find it necessary to discharge you from care, any outstanding fees become immediately due and payable. 2. I understand the bookkeeping savings of 20% is for a one-time payment, which saves Willow Creek Chiropractic time and money over the course of my care plan. If I terminate care before the end of the care plan, I will only pay for the services that have been rendered, at the normal fees without the 20% savings. 3. [handwritten X through “3.”] Care-Credit has a 10% processing fee on the amount borrowed. In the case of a refund, all monies for unused services will be refunded minus the processing fee and used services. ## FAMILY: 1. All children must be checked within 2 weeks of a parent starting care. This will be at the doctor’s expense. ## APPOINTMENTS: 1. The visit frequency must be kept by the patient according to the schedule. 2. On the occasion that you do have to miss an appointment please call, it significantly reduces the amount of work of the front desk staff and allows us to reschedule your next visit. 3. Missed appointments must be made up within one week. In the event you are out of town visits may be increased before and after your missed appointment to keep your schedule on track. Payment Plan: $ __________ Due on: __________ # of Payments: ______ Paid through: __________ Patient Signature: ______________________________ Staff Signature: ______________________________ Date: __________ Notes: Archival source only. Historical discount, financing, interest, collections, refunds, mandatory child checks and care claims require current clinical/legal review before use. Care Credit item has an X at its item number; status unresolved. ### rec-informed-consent · Informed consent form (historical) Sources: IMG_0286 # Informed Consent For Chiropractic Care Chiropractic care, like all forms of health care, while offering considerable benefit may also provide some level of risk. This level of risk is most often very minimal, yet in rare cases injury had been associated with chiropractic care. The types of complications that have been reported secondary to chiropractic care include sprain/strain injuries, irritation of a disc condition, an rarely, fractures. One of the rarest complications associated with chiropractic care, occurring at a rate between one instance per million to one in two million cervical spine adjustments may be a vertebral artery injury that could lead to stroke. Prior to receiving chiropractic care in this chiropractic office, a health history and physical examination will be completed. These procedures are performed to assess your specific condition, your overall health and, in particular, your spine health. These procedures will assist us in determining if chiropractic care is needed, or if any further examinations or studies are needed. In addition they will help us determine if there is any reason to modify your care or provide you with a referral to another health care provider. All relevant findings will be reported to you along with a care plan prior to beginning care. I understand and accept that there are risks associated with chiropractic care and give my consent to the examinations that the doctor deems necessary, and to the chiropractic care including spinal adjustments, as reported following my assessment Patient Name (Printed)　　　　　　　　　Relationship to patient ____________________________　　　　____________________________ Patient or legal Guardian Signature　　　　Date ____________________________　　　　____________________________ Witness ____________________________ Notes: Archive only; quoted numerical risks and comparative table have not been verified. Do not substitute this old form for current clinician-approved informed consent. ### care-primary-script · Primary concern and appointment script Sources: IMG_0294 **PRIMARY SCRIPT** **Do you have any health problems that concern you?** **Do you mind if I ask you what it is?** **I'm sorry to hear that. (get them talking)** (Turn up the heat – How long have you had it? When its at its worse what does it feel like? How does it effect your work? How old does it make you feel?....) **Would you mind if I were to explain how chiropractic might be able to help you with _____?** **Chiropractors work with physical stress.** **Have you ever had a rock in your shoe? The rock was putting physical pressure on the nerves in your foot.** **How did it feel? (hurt)** It hurt because the rock was putting pressure on the nerve in your foot. **What did you do for it? (removed it)** **Did it temporarily or permanently correct the problem? (permanently)** When you have physical pressure on a nerve the best thing to do is to physically remove it just like you did. When a bone in your spine gets out of alignment in puts pressure on the nerves and spinal cord. This pressure interferes with the messages that come from the brain and if you have pressure on a nerve of pain you get pain. When you have pressure on a nerve of function you loose function. The way to know if it is a chemical or physical stress that is causing a problem is to remove the chemical (aspirin) and see if the symptoms re-appear. If they come back, then the drug was only masking the problem. **I'm not saying that you do have a physical pressure on your nerve causing _____ but I think it is worth a chance to find out. Don't you?** **Is morning or afternoon better for you?** **We can get you in Tuesday or Wednesday afternoon, which one is better? (next 2 blocks of time)** **We have an opening at 2 or 3:30 which works better for you?** **Because the doctor's time is valuable and there is no charge for you to meet with him. Is there any reason you would not be able to keep this appointment?** (this anchors the appointment) Give this appointment to the Receptionist so she can place it in the manual appointment book. She needs the NAME, PHONE #, and REFERRAL SOURCE. Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-first-adjustment-call · First-adjustment evening call Sources: IMG_0295 ### First Adjustment Call After a patient receives their first adjustment, their name and phone numbers will be placed on the ‘Dr. call list’. Before leaving for the day, call each of the 1st adjustments to see how they are doing following their adjustment. **“Hi name this is Dr. ______ from Willow Creek Chiropractic. I’m calling to see how you responded after your first adjustment.”** GOOD – **“That is what we expect. Have a good night and we will see you on your next visit.”** BAD – **“That is what we expect. Your body is detoxifying and will be releasing toxins that can make you sore.”** - Give ice or other instructions to get them through the night till their next appointment. - Make sure they have another appointment the next day. If not then make one, even if it is on a day we are closed. Remember you have about 72 hours to get them feeling better or they will dump you as their doctor. Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-energy-check · Affect and concern check during visit Sources: IMG_0296 **Keeping Patients training:** **The regular patient walks into the adjusting area, what should you be thinking when you see them?** How is their energy? **Where can low energy come from?** Low energy can come from a death, bad last adjustment, new accident, stressful day at work etc. **You don't know why they have low energy so what do you say?** “What’s going on?” or “Is something wrong?” (then address the concern or issue) **What is your main objective here?** Show concern and raise them a tone. **What may be the last thing you say when they leave you?** “You’re in the right place.” Or “This adjustment is going to relieve a lot of stress for you, you’re going to do fine.” Or “It’s going to take time, hang in there, you’re on the right path.” **If I pretend to not notice their low tone what will happen?** They will feel you are insensitive, you won’t bond, and they will leave and will be scratching your head as to why. **If the patient has a high tone what would you say before the adjustment?** “Good to see you, let’s check you.” Or “There’s the man, good to see you.” Or “Wow you look good, let’s check you.” **What might you say after a high tone adjustment?** “You are doing great, these adjustments are starting to hold, see you Wednesday.” “The power is on, see you Wednesday.” **How much pain do you want to create on the patient's first adjustment?** None, you want to relieve their pain. Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-returning-relief · Returning inactive patient and relief/corrective choice Sources: IMG_0297 **An inactive patient returns, what happens:** - Enrollment pulls x-rays, takes the patient back to room 4 and does a consultation looking for AA, new injury, why now they want to come back etc. Then gets the doctor. - The doctor goes over the x-rays and educates the patient. - Tells the patient they have 2 choices: 1- relief care. (as soon as you are out of pain we stop, and when the pain comes back we do it again. 2- corrective care (that is where we fix the problem and then keep it there) Which one do you want? **If they choose relief care then what do you do?** “Ok, I want to see you M, W, F (3 days) and on Friday if you are out of pain, then that will be your last visit until the pain comes back and then we will do it again.” **On that Friday the patient is still not 100% out of pain what do you say?** “We are almost there, I need to see you 2 more days, can you handle that?” **After their first 3 visits they are out of pain, what do you say?** “Now you are out of pain you have 2 choices: 1. Come back when the pain comes back and we can do it again. Or 2. Keep working on it so it doesn’t keep coming back. Which one do you want?” **Relief only - What do you say?** “Ok we won’t set up any other appointments and we may just check in on you throughout the year to see how you are doing.” Have the receptionist write down in her desk calendar to check on him in ____ months. **Corrective - What do you do?** Put them in the room to meet with enrollment and work out the details like money and calendar. Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-special-consult · Many questions: special consultation handoff Sources: IMG_0298 **The patient has a lot of questions during adjusting hours:** “Mrs. Jones you have a lot of questions and I want to answer each one of them, talk to the receptionist and have her schedule some time during our non-adjusting hours, when we won't be interrupted, OK?”. Notes: Exact source passage, including stage directions. Historical names, location and prices are not current configuration. ### care-inactive-recall · Missed ROF, missed visits and long-absence calls Sources: IMG_0299 ***Missed ROF:*** **“Name this is Dr. _____. We had you scheduled to go over what I found on your x-rays on _____. Is everything ok? I did find some things that concern me, and I want to sit down with you and show them to you. Is morning or afternoon better for you?”** ***Missed several appointments:*** **“Name, this is Dr. _____. I haven’t seen you for awhile. Is everything OK?”** (find out what needs to be addressed in order for them to come back in.) ***Haven’t been in for a long time:*** **“Hi name this is Dr. _____ with Willow Creek Chiropractic. Dr. Thomas asked me to call you and see how you are doing. How is that pain you had in your _____?”** [get them talking about the symptoms they came in with originally to see if they still have them or if they have returned. If there is a new concern then using the primary script and get them talking about it. Then explain how we might be able to help them. Offer a no-charge evaluation to see if we can help.] *This is an activity that if done properly will provide a continuous stream of repeat business that will increase your patient visits weekly.* Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-visit-exit · Confirm the next visit Sources: IMG_0300 10. **Next appointment** 11. Pay attention to the patient’s calendar and their next visit. Make sure the schedule is marked correctly and remind them of their next appointment. **“Check you Wednesday!”** Notes: Exact source passage, including stage directions. Historical names, location and prices are not current configuration. ### care-day-one-consult · Day 1 consultation explanation Sources: IMG_0301 1. Introduce yourself, take to a room, clear out + or - experiences with chiropractic. 2. The consultation: Do the primary script with their symptoms, your goal is to get them to open up about their health concerns, especially their primary ones. If they say they don’t have anything they want to change about their health, then it is not likely they will return to find the results of their x-rays. (Only 1 in a 100 will accept care without symptoms, just because they get the big idea. Therefore unless they really want to get rid of a problem or they really get the big idea, don’t take x-rays.) Find their main concern: “Which health problem concerns you the most?” Why? “Tell me about it.” “How does it affect you at work, home, hobbies...?” “How old did you think that people should be when they had these problems?” .......... [The goal is to get them to RUN on the tone scale. A place mentally that they cannot continue living with their problems] “Let me explain how chiropractic works. Your brain controls your entire body through the nervous system. These nerves cause pain and go _____, and these nerves go to your organs. Sometimes these bones can get knocked out of place, and when that happens the bone hits these nerves and puts pressure on them. * We call this mis-alignment a subluxation or bone out of place. This pressure interferes with the signal and if the bone is hitting a nerve of pain you will get pain. If it is hitting a nerve that controls an function, then you lose function and the tissue or organ becomes diseased and dies. And the bones begin to fuse together like these. (show model) If I find that you have bones out-of-place causing your _____ and _____. Then we are going to be able to help you. If not then we will find someone who can. Let’s hope I find something.” Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-day-one-rof · Evening review, support person and ROF attendance Sources: IMG_0302 [“Tonight I am going to spend detailed time going over your examination and x-ray findings. Tomorrow I will tell you what I found. The x-rays will tell me if it is a ligament or muscle type problem, of if you do have a subluxation. If you do have a subluxation it will tell me exactly where it is, how long it has been there, and what I need to do to get rid of it. Do you have any questions?” **“Are you married or do you have a significant other?** I would like him/her to come with you when I go over your x-rays so he/she can see what I have found. Would there be any reason he/she would not be able to come with you on your next visit?” **Make the appointment –** “I go over x-rays outside of my adjusting hours so I can spend the time we need without interruptions. My next time I have available is ______.” **Pull out the ROF paper and fill out the information, give to the patient and say,** “This will be the most important appointment you will ever have in our office. Here you will understand exactly how you are going to be able to get rid of your problems permanently. We love children but this is one time you will want to get a baby sitter. If your babysitter falls through at the last minute, still come and my staff will take care of your child so you don’t miss any information. Plan on an hour and don’t schedule anything right after in case you have extra questions. And arrive 5 minutes early because I will start right at ______. There may be others there to hear the basic information at first, and then I will take you in a private room and go over your x-rays.” **If no fees are due, they are free to go with their paper of the ROF. If there are fees owed then walk them to the receptionist so she can collect the money and then she will release them.** Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-day-one-training · Day 1 training answers, fees and support-person scripts Sources: IMG_0303 Training practice for Day 1: **What is the reason a new patient would come into our office?** Because they have a problem that they want to get rid of, or they want a massage from the Public Gift Certificate. 1. **How do we make sure they want to get rid of it?** By doing the primary script. 2. **In the consultation there are 3 main things the Enrollment staff will do. What are they?** 1. Discover the and handle the positives and negatives the patient has heard or experienced. 2. Discover the patient’s most pressing symptoms. 3. Teach them what a Subluxation is, where the nerves go to on both charts, and how they don’t just cause pain but cause organs to malfunction and die. 3. **What is the last thing the Enrollment staff will say before coming to get the doctor?** If you have pressure on your nerve causing your _____ then the doctor will find it and you are in the right place, he can help you. If not then he will find someone who can. Let’s hope he finds something. 4. **When the doctor enters the room for the patient’s day 1, in order list the components of your visit.** 1. Greet kindly. 2. Acknowledge the referral source if applicable. 3. “It looks like we have some things to go over, go ahead and stand up right here.” 4. Exam. 5. Explain findings. 6. Explain x-rays and fees. 7. Explain a ROF needs to be set up with spouse (or other). 5. **What x-rays will you take?** If the NP is from a screening take a Lateral Cervical and A-P Low back. If you feel another picture is needed then take it. If we will be billing insurance for the x-rays then take the appropriate series. If it is an AUTO or Work Comp then take all view necessary including flexion and extension of cervical. 6. **What are you going to charge the patient?** Patient referrals - free exam, charge all else. Family within 2 weeks - Free exam, x-rays. Family after 2 weeks - Free exam. PGC or Health fair - Free exam, x-rays, possible massage. 7. **What is the script the doctor is going to use in telling the patient what the fees are?** Cash patient referral - I need ____ x-rays, they are $30 each, that would be _____. Do you have any questions? Insurance patient (you think they may be covered)- The exam is 30 each of the x-rays are 30 a piece, that would be ____. I understand you may have insurance, go ahead and make your co-pay today and we will check on your coverage for you. Do you have any questions? 8. **Who needs to come to the ROF with the patient?** Spouse, significant other, or anyone this patient is going to need to help make financial decisions or who’s opinion may interfere with the patient receiving care. 9. **How do you explain that someone needs to come with them to the ROF?** Spouse - “Now (name) I understand you are married. If I am right and you do have subluxations causing your (symptoms) then I will need to explain your options with you and your spouse since you will have decisions to make. Is there any reason your spouse would not be able to a come with you?” Handle any objection that comes your way. Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-day-one-collection · Day 1 itemized payment collection Sources: IMG_0304 **10. What is the script the Receptionist uses to tell the patient what is owed for Day 1?** “Your examination was $____, each x-ray was $30, so your total for today is $____. How would you like to take care of that, cash, check or credit card? (If there are any discounts then after repeating the script, and a brief pause say, “However it looks like you came in from ______, so your total will just be _____. Or will be at no cost. Notes: Historical fees must be replaced by approved current pricing. Preserve itemized charge and discount explanation. ### care-weak-day-one · Day 1 uncertainty call and spouse branches Sources: IMG_0304 **11. If the patient seems insincere or you feel it was a weak Day 1 after the patient left, what will you do to strengthen it?** Later that day or that night give the patient a call. “(Name) this is Dr. _____. I just got through going over your x-rays, you do have subluxations causing your (symptoms) it was worse than you thought. The good news is it is correctable. We have you scheduled tomorrow at ____, I everything ready to show you what we found. Do you have any questions? (If questions are about more detail of what you found just say we will be going over that when you come in. You are making sure he understands the seriousness of what was found on x-ray and firming up the appointment.) If the patient is bringing a spouse and the spouse answers the phone – “Hello (name) this is Dr. ______ from Willow Creek Chiropractic. Were you aware that (name) came into our office today? Yes. He came in to see if we could find out what was causing his (symptoms). We found out what the problem is and set up a time tomorrow at ____ for both of you to go over our findings. Did he mention that to you?” Yes we will see you then. Were you aware he came into our office today? No he didn’t mention anything – Is he there now, can you get him on the phone too, do you have 2 phones so I can talk to both of you at the same time? When they are both on the phone. “Mary, John came into the office today. We took some x-rays and found some things we are concerned about. We have set up a time tomorrow at 3pm for you and John to go over my findings with both of you. Does that time work for you? Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. Spouse contact requires patient authorization; do not overstate films. ### care-mini-day-two · Modified Day 2 when ROF is delayed Sources: IMG_0305 Most of the time the patient's day 2 will be their REPORT OF FINDINGS. (see section 15) However, if the patient for some reason cannot come to an ROF for several days, it will be important for the patient to be seen and adjusted before that ROF. In this case the patient will have a modified day 2 as follows: 1. The patient will be placed in a consultation room and the doctor will take the file in the room (no x-rays are in the room). 2. The doctor says the following: “_____ I have had a chance to over your x-rays and examination and you do have Subluxations. This is one of the worse problems we deal with. It is not just causing your pain it is causing damage to the nerves and organs. Today we are going to start with a small adjustment to release this pressure and see how you are going to respond to it. __________ Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-first-adjustment · First adjustment introduction and response observation Sources: IMG_0305 The Day 2 just came out of the ROF and enrollment places them face down. **With the patient face down what do you do and say?** - Place your hand on their back and say, “Do you understand what the problem is now? I'll show you how we are going to fix it. (then go through each step of the adjustment, explaining as you go what and why your are doing it. **How long is your first adjustment going to take?** - 1 minute or less **What is the goal of the first adjustment?** - Show and tell the process of correction. - Show it doesn't take a long visit? - Get symptomatic results. **What do you say when you finish the adjustment?** - “Now roll to the side and use your elbow and push up. Now this is how you also get in and out of bed each time.” **Watching how they get up and move, what are you looking for?** - To see if they are better or worse. **Better – what do you say?** - “It feels good doesn't it? I told you, you were in the right place.” **Worse – What do you say?** Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-first-adjustment-response · First adjustment worse/unclear response Sources: IMG_0306 • “Now lay down on your ____.” (do another adjustment in a different technique) **Still not better, what do you say?** • “The joint is now moving so the healing can begin. I want you to go home and put some ice on it and I need to see you tomorrow. Can you handle that?” **If you can’t tell if they are better or worse, what do you say?** • What does that feel like? (then do or say the appropriate action from above.) Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-no-adjustment · Holding adjustment: no charge and reception handoff Sources: IMG_0306 • “Wow everything is still moving, you are still holding my last adjustment, you don’t need an adjustment today, we will see you Wednesday. (symptoms have to be good and walk them to the front and announce to the receptionist that ____ is still holding her adjustment and you will see her on Wednesday and there is no charge for today. She should say, “Congratulations, we will just see you Wednesday then.) Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-barrier-rescue · Unresolved enrollment barrier: doctor rescue Sources: IMG_0307 ***On Day 2 enrollment is unable to work out anything for them to start care, patient wants to go home and think about it, or has a barrier that they haven't been able to overcome.*** **What should enrollment do?** - "OK, let me get the doctor and see if he has any other questions for you." Then stand outside the door, wait for you to finish your adjustment, get you in to see if you can do anything to keep them. **What should you do when you go in the room?** - Go in and look at x-rays and act as though you are seeing if the ROFer did her job and ask a couple questions about the films to see if they understand what is going to happen if they leave it alone. - Find out the barrier or confirm it with the patient. - If you can resolve their concerns then turn it back over to enrollment to do $ and Calendar. If not then do the following: - Tells the patient they have 2 choices: 1- relief care. (as soon as you are out of pain we stop, and when the pain comes back we do it again. 2- corrective care (that is where we fix the problem and then keep it there) Which one do you want? Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-distance-barrier · Distance concern and manager handoff Sources: IMG_0307 **This is so far for me to travel, can you recommend a chiropractor closer to my home?** "I know it is a distance. The closest chiropractor that I can recommend that does what we do is in Bountiful and Orem. Because there are so few that correct the spine, that is why some of our patients travel from Green River and Cedar city. Let's see what we can do with your schedule." (Move them to room 4 with the manager to work it out) Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. Named locations and exclusivity claims are historical; do not copy as current facts. ### care-relief-closure · Relief-only check-in or corrective enrollment Sources: IMG_0308 **Relief only - What do you say?** “Ok we won’t set up any other appointments and we may just check in on you throughout the year to see how you are doing.” Have the receptionist write down in her desk calendar to check on him in ___ months. **Corrective - What do you do?** Put them in the room to meet with enrollment and work out the details like money and calendar. Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-re-exam-questions · Four re-exam review and commitment questions Sources: IMG_0309 - 4 questions are gone over 1. **What do you remember about your x-rays?** 2. **What is it doing to your spinal cord, nerves and organs?** 3. **What will happen if it is not corrected?** 4. **You are scheduled ____ times in the next month. On a scale of 1-10. How committed are you to keeping all of these appointments.** (If less than a 10 then handle it and get them to a 10) Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-re-exam-practice · Re-exam training and question variant Sources: IMG_0310 # Re-exams practice **What are the 2 purposes of a re-exam?** - To sit the patient down and remind them about you findings, tell them the part you are doing to fix it and make sure they know their part in fixing it. - To get referrals. **When are the 2 times a re-exam is performed?** - Every grey line which is every 12 visits. - Whenever you feel like you need to tighten the grip on a patient that is starting to slip away. **Where are the 2 places a re-exam can be performed?** - On the table - In a room. **What happens in a re-exam?** - Repeat positive tests and measure their progress. - Review x-ray findings with the 4 questions. - See if the patient is compliant with rehab and keeping their appointments. - See if there any barriers to following through with the whole program. - Obtain referrals, testimonials if they are improving. Or to make recommendations if they are not improving. **What are the 4 questions in a patient is asked?** 1. What do you remember about your x-rays? 2. What is it doing to your spinal cord organs and nerves? 3. What will happen if it is left uncorrected? 4. We have you scheduled _____ for _____ weeks. How committed are you to keeping all of those appointments on a scale of 1-10? What's stopping you from being a 10? Handle any objections. Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-re-report-improved · Improved comparison-film report Sources: IMG_0310 **The new films are improved compared to the first. What do you say?** - This is your first film. What was wrong with it? - This is your follow-up film. What do you see? - That is right it is improved about _____%. You have done what we have asked and you are on track. Now we are changing your visit schedule to _____. Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-re-report-worse · Worse comparison-film technical checks Sources: IMG_0310, IMG_0311 **The new films are worse when compared to the first. What do you say?** - You should have noticed this and made sure the markings were made properly. - You should have checked to make sure the positioning was correct. - If one of the above is incorrect then remark or retake the films and do the RR next visit. - If everything was done correctly then possible reasons for them getting worse could be that the patient is not doing their homework with their rehab and just like when 2 people are playing tug-o-war and one lets go, the other will fall away first before come back up. Our adjustments release locked up joints and as we push them, they actually get a bit worse before getting better, especially the first 30 days. That is why the first film is taken at least at the 2 month mark. Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. Do not presume rehab nonadherence or normal deterioration. ### care-weekly-recommit · Friday relief-care recommitment and daily rhythm Sources: IMG_0322 Occasionally you will have a patient that is paying as they go or are only interested in RELIEF care. Tell them what you are finding and sell them a week at a time. So on Friday say “You’re improving but I need to see you 3 times next week. Can you handle that?” [Many patients that go day to day or week to week have converted over to correction because of the improvements seen and the continued education. Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-first-response-expectations · Historical first-adjustment expectations Sources: IMG_0322 **1st Adjustment** **“How do you feel?”** **“The joints are now moving and it can start healing. Later you are going to one of 3 ways. #1 you will feel great. #2 you will feel achy as your body will be releasing lactic acid. #3 You will feel nothing. All of these are normal following a patient’s first adjustment.”** Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. Blanket lactic-acid/normal-response claims are review-only. ### care-table-talk-efficiency · Focused explanation and question overflow Sources: IMG_0324 Watch to see that the patient is symptomatically OK with it. If not then change techniques to accommodate discomfort but still getting changes in the spine. # Shortcuts to Faster Adjusting (Goal = the two minute adjustment on the average) If you know that on your wife you are going to adjust C2 body right, C5 posterior, T6 anterior, and the left PI ileum. It would take you about 30 seconds, because you know exactly what to do and there would be no talking. The reason the average adjustment in the average practice takes 20 minutes is because they don’t know what they are doing, are disorganized, undisciplined, and are brown nosing, or kissing up to the patient so they will return another day and spend more money. Stop talking! Say what you need to in as few words as possible. Fewer words = increases impact and certainty. In today’s fast pace life the patient of today wants something else. They want a good product, at a good price. They want to see the value in it. And they don’t want to have to wait and be inconvenienced. Nobody wants the slowest computer. During the minute adjustment, if you are focused, have good hands that know how to touch, where to touch and how to give a gentle adjustment that relieves their symptoms and corrects their spine. And have a smile welcoming them, and words reporting what you are finding, how you are going to correct it and the wonderful benefits they will receive by freeing up their interference. (Feel that? That’s why I check you 3 times per week, we’ve got work to do. This nerve goes to your stomach. People who have ulcers have them because of the interference at this point. By taking care of yourself you’ll be able to really enjoy your life.........) The faster that you have to go then the slower your hands need to move! (perception) With lots of questions you can set up a special consultation time, or say something like, “Now have you attended our orientation? No wonder you have so many questions. Wednesday night we go over all of that for you.” - Know why they came to you - Know their x-rays - Know the order in which to adjust with minimal turning - Patient started face down - Double pat, “Powers on - check you Wednesday” - Turn and walk away Signs that a patient is going to fire you. 1. Missed appointments. 2. Low energy Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-historical-adverse-objections · Historical adverse-response replies and unanswered objections Sources: IMG_0326
Objections:
**Objection:** I have more headaches **Handle:** “When I release the pressure your body will release a lot of toxins that can cause a headache, it should be gone soon. **Do:** Change the adjustment and quit causing the headaches **Objection:** I threw up after the adjustment? **Handle:** “Awesome, when your body has toxins in it that it needs to get out, it either comes out of your mouth, your bottom or your skin. How did you feel afterwards?” **Do:** No need to change anything. It usually only happens once and to about 1 in a 100. I think you hurt my rib “Why am I in more pain I hurt more after your adjustment You are so big I think you will hurt me I would be afraid for you to adjust my child Why should a baby get an adjustment My husband is an MD and he thinks you are quacks I head you can get a stroke My friend came here and she hates you guys I didn't have much discomfort before coming in here, how come I hurt more now? My friend said you messed up her finances and doesn't want to come back. **Objection** - The patient is sitting on the table before the adjustment and doesn't want to lay face down because it hurts their back. **Handle** – “Go ahead and lay face down, take some deep breaths and relax and I will be right with you”. Then go to the next person that is laying down doing what he was supposed to do, and come back to the one you told to lay down. Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. Review-only; do not auto-deliver toxin/vomiting reassurance or advice to ignore symptoms. ### care-treatment-explanations · Clinical explanation training and spine-specialist objection Sources: IMG_0327, IMG_0328 # TRAINING YOUR MOUTH **Practice training-regular patients:** **I know exactly what is going on with the patient's spine and how to correct it by:** - When I marked the x-rays I clearly marked the Dr. Use Form so everything I need to know gets transferred to the travel card. - I mark down my techniques in the comment section. - When I figure out the right combination I circle it, so myself and others know exactly what works, what they like and so I don't have to think about it and re-figure it out each time. **How are you going to put that curve back in my neck?** - This drop head piece allows me to begin putting the bones into the forward curve so each time I will be doing that. - You will be using a wedge to help hold that position. - You will be using the wall traction and head weights to help with the correction process. **How are you going to fix my scoliosis?** - By putting the curve back into the neck the side curves will be easier to correct. - The bones in your spine that are putting pressure on your nerves are causing the muscles to pull harder on one side than the other, and that bends the spine to the side. When I release that pressure the muscles will pull more evenly. - You will use a heal lift to help balance the low back, and do exercises with a wedge, head and shoulder weights that will retrain your proper posture. **Do I have a herniated disk?** - Yes, and as I keep putting it back where it belongs, they are never going to cut you open. **How are you going to fix my disk?** - When you are face down I am going to stretch these two areas apart which will pull the disc back inside. - Then I am going to push this bone down to sit under the disc. - Then when you are on your back I am going to rock both hips into a better position to hold that disc in. **I demonstrate to the patient that I know what I am doing by:** - Telling them exactly what I am going to do to not only eliminate their symptoms but correct what caused it. - Walk them through on each visit what I found, good or bad. (1 minute ROF) - Give them instructions based on what I found. - Make sure we are on the same page. (can you handle that?) **The way I answer a patient's questions or concerns is to:** - Look at them in the eye. - Give them a short, to the point answer. **What do you do if the patient has too many questions for adjusting hours?** I say, “You have some really great questions, and I want to answer all of them. Would you talk to the receptionist and set up a special consultation so I can block off some time to answer all of them?” **Maybe I should go to a spine specialist?** “You see this bone out of place on this poster? This bone has moved onto the nerve, this is your problem. Medical doctors give medication to cover up the symptoms of this problem, and when that doesn't work they do surgery on it and fuse it permanently in the wrong position. A spine specialist would move the bone into the correct position so the body can heal. That is what we do. A chiropractor who specializes in correcting this is a true spine specialist. **Check you Wednesday.”** Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-complaint-calendar · Clinical/billing concerns and attendance changes Sources: IMG_0328 **My neck really hurts.** “Well lay down and let's check you.” (don't start at the neck) **You haven't done anything for my arm. It's still going numb.** **See that right there?** That's your problem. Healing takes time, see you Monday. **You hurt me, I'm not coming back.** “That bone is jammed on that nerve and needs to be corrected. Dr. Thomas has a very gentle technique and can free it up without causing you any discomfort. I want you to see him.” (set the appointment) **I think your billing is dishonest.** “Come over here. (take to room 4) I don't understand, what are you referring to?” (Discover the concern, get the office manager or appropriate person, bring them to the room and explain to the patient and staff your understanding of what is wrong) “Can you handle this? ____ has damage in her spine and I want to correct it, but this needs to be handled. ____ will handle this, and I will see you on Monday.” **Patient generally has low energy, is a pessimist.** - Usually means one of the following: - You are hurting them in the adjustment. - Their symptoms are not improving. - If the above are not true then give them tons of energy, love them up, tell them they are in the right place and how much you appreciate them. Check you Monday. - If you can't figure it out then do a special consultation. “ Is everything ok. You seem like you have the weight of the world on your shoulder.” - If you think they are just dead weight and need to be kicked out of the office, then have the other doctor take them over and see what he can do with them. **Patient calendar is 2x and the patient tells the doctor that they can only come in 1x.** **What's going on?** (listen, fix it) **Patient calendar is 2x and the patient tells the receptionist they can only come in 1x.** “Oh you mean just this week?” (If so then find out the calendar for this week and book MUD for next week.) (If they mean from here on out, then if you can get the doctor then get him, and if not then get the manager to take to room 4 and discuss.) **How does the doctor confirm a calendar?** I need to see you 2x a week. Can you handle that? (If no, “What's going on?”) **The patient is changing their own calendar.** - Room 4, or special consultation, go over x-rays, explain what is happening and what can be done to fix it. “What would you like?” - Take what they give you and then build on it daily. Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-new-patient-phrases · New patient, consultation and ROF phrase bank Sources: IMG_0329 - Hello, I'm Dr. ________. Are you ready to get down to work? - The purpose of the x-ray is to find your imbalance. - Do your children have these problems? - Do you agree with this statement? - the body can heal itself. - Do you want to be healthy the rest of your life? - What have you been doing for this? Has it been working? - How's your budget? - If you're committed - I'm committed. (hand them card with home phone on it) - Are you into long term or quick fix? - Do you want to participate in your care? Or do you want me to tell you what to do? **Consultation:** - Discover the patient's problem and why coming in, verbalize it back to the pt. - Ask open ended questions, give ROF and draw out a commitment. - Explain the benefits/attitude of health (increased energy and work capability, no drugs, no pain) - Most important thing on first visit is to GRAB THIER ATTENTION. - Are you available or are you in for a quick fix? We're excited you're here, we're going to get you so healthy that you're going to be dancing in and out of here. - Look at hx taken by CA, then look like its overwhelming, shake hands with pt, introduce yourself and - say, "there's a lot of writing in this paperwork - we've got a lot of work to do. - Never use the word LITTLE. - How does that feel to you? It doesn't feel good to me. Do you understand you have a problem? - The purpose of the x-ray is to find your imbalance. - Do your children have these problems? - Do you agree with this statement? - the body can heal itself. - Do you want to be healthy the rest of your life? - What have you been doing for this? Has it been working? - How's your budget? - Are you into long term or quick fix? - Do you want to participate in your care? Or do you want me to tell you what to do? **ROF** - You know you've got a problem. - What this means to you is, we can help. - It's going to take some time. - We are going to monitor your nervous system. - If I help you will you help me? - Calendar - We need to handle finances don't you think? - We're going to monitor the imbalance in your body. - The longer you stay the cheaper it is. - Do you want relief or stabilization? - How would you feel when your child doesn't get sick anymore? - Can you handle that? - Daily at first then we'll have a direction and then we can maybe change the schedule. We do some exercise, talk about a little diet. We'll take care of you. - Get off the gloom and doom wagon and get on the FREEDOM AND RELEASE wagon. Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-rof-table-phrases · ROF continuation and table-talk phrase bank Sources: IMG_0330 - Here is your problem, I can help you. We're going to see you daily in the beginning, can you handle that? - It's going to take time. Spread the word. - 3x a week for 12 weeks , may go more, may go less, can you handle that? - We better talk $ don't you think?p - Is that what you want? - Can you handle that? - We're going to work on this together - Have your wife fill this out and see if she has any problems. - If you get adjusted on a regular basis, let me tell you the results. I haven't been to an MD in 16 years.... **Table Talk** Here are some phrases to read over multiple times so they can become part of you. Soon they will start coming our of your mouth. Short – Direct answers or comments show that you know what you are talking about. The lengthier the answer, the more it sounds like you are trying to sell yourself on the idea or someone else. - It looks bad to me, I can see why you're here. - It looks like we've got work to do. - Take it easy, we've got work to do. - You got yourself in this mess I didn't. - There it is, there it is. - Let's measure your success. - You know why you're sick? You're undisciplined. My job is to help you get disciplined. - Acute pain = constant, Subacute = pain comes and goes. - Its a great day, lets check you, face down. - (Friday) I'm not happy with this. Let's see you 3x next week, can you handle that? - (3rd visit) What word do you remember from our last visit? (do a mini report if they didn't get it) - The benifits of bringing in your family are __________. - MONDAY = 4 cards referal day, WEDNESDAY = RE day . FRIDAY = recommit for next week. - Take out the words “I, WE, MINE” and put in “YOU and YOUR (you have work to do) - OUT OF BALANCE - Let's release you. Let's release this. - You must keep selling the pt on the next visit, sell them today on tomorrows visit. - When I help you will you help me? - Replace the word SICK with INTERFERENCE - Chiropractic restores nerve flow - NUTRITION is used to replace damaged tissue. - There is no process that doesn't take time. - OTHERS may never know unless you tell them. - Nature needs no help , just no interference. - YOUR JOB IS TO COME. MY JOB IS TO GET RID OF NERVE INTERFERENCE and allow your body to - balance itself. Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-greeting-exit-phrases · Greeting, returning inactive and visit exit phrases Sources: IMG_0331 - It's going to take time and when your HEALED we're going to BOOT you out of this office. - If I cut you - you will heal, everyone has the power to heal. - YOU BE HERE MONDAY! - REGENERATE (not degenerate, it motivates the pt. - (the busier you are the slower the hands move and the faster the mouth moves.) - (keep the talk about diet, life style changes... not vacations..) - HOW AM I DOING? - THERE'S YOUR PROBLEM - SPREAD THE WORD - HARNESS THE POWER. - CHECK YOU WED, SPREAD THE WORD. - YOU HAVE INTERFERENCE - YOU HAVE INTERNAL STRESS - INTERFERENCE CAUSES MALFUNCTION OF ALL LIFE SUPPORT SYSTEMS - YOUR BODY IS ADAPTING - YOUR BODY IS DETOXIFING - Turn on the power. - OK we've got work to do. - You want to get well don't you? We're going to work on this together. - Lets free you up. - It looks bad to me, I can see why you're here. It looks like we've got work to do. - Take it easy, we've got work to do. You got yourself in this mess I didn't. - (I've got to come the rest of my life?) Don't do that to me, Lets take it a week at a time. - Let's release you. Let's release this. - You must keep selling the pt on the next visit, sell them today on tomorrows visit. - When I help you will you help me? - There is no process that doesn't take time. - (late on payment pts) I'm giving you the care but you're lacking in the contribution department. - You want to get well don't you? We're going to work on this together. - Lets free you up. - Feel that - There it is - That is why I see you 3x a week. **Greeting:** - Good to see you, we're glad you came in today. - Lay down lets check you. - Its a great day, lets check you, face down. **Returning inactive patient** - Its good to see you again. - We'll get you back on track. - [Don't chastise them, just be glad they are back.] **End of adjustment:** - Power's on - We'll check you on [blank]. - You've been missing your appointments, I'm concerned, you need to be seen 3x a week, can you handle that? - Spread the word - see you Wednesday. - Thank you for coming. Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-objection-phrase-bank · Historical objection replies and prospect greeting Sources: IMG_0332 - *(Friday)* I'm not happy with this. Let's see you 3x next week, can you handle that? ## Problems - How long do I need to come? *“Let's just focus on this week, we'll reevaluate in 4-6 weeks and if you're stabilized, you're out of here.”* - My neck hurts. *“Pain is good, its a point you start from.”* - What's wrong with me? *“You're out of balance.”* - I've been coming in for 18 mos. *“You must have been out of balance for an awful long time before coming in.”* - How long do I need to keep coming? *“It depends on how long it takes you to go from here to here.”* - I've got to come the rest of my life? *“Don't do that to me, Lets take it a week at a time.”* *“Don't stress me out just be here this week.”* - What do you think about ______: *“What do you think about it.”* - Patient is sitting on the table. *“Lay down take 10 deep breaths and I'll be right back.”* - When pt has DO NOT OPEN sign on them. Don't open it. - I have pain! *“On the table lets check you.”* Or *“That's why you're here let's check you.”* - Non-paying patient. *“We have an overhead, we all need to contribute. Give ____ a few bucks at the front desk ok?”* - Non-paying patient *“I'm giving you the care but you're lacking in the contribution department.”* - I HAVE A HEADACHE! *“No you don't, you have a symptom which is a distortion of your energy pattern between your brain cell and your tissue cell. The interference needs to be released to allow the energy to flow.”* - I can't handle 3x. *“What can you handle?”* I can handle 2x. *“OK we'll stay with 2x.”* - YOU CHARGE TOO MUCH! *“That's not the problem, you don't have any money.”* - IMMUNIZATION? *“When they start immunizing pregnant women, then I'll immunize my children.”* - Patient that doesn't keep appts. or comes to your house on Saturday but not during the week when they can. *“In our office we have a rule. If you're not committed, neither am I.”* - Patient that is flaky. *“If you're not coming back tell me now”.* (or) *“Are you going to be back on wed.?”* - HOW LONG? *“You have not had sufficient treatment to feel better and train the muscles......”* - I feel great. *“Feeling good is not the same as being STABILIZED”* - You are amazing. *“Thank you but I move the bone and God does the healing.”* *“Who do you know with ___?”* *“Would you mind if I were to try to help them?”* - Indecision. *“You need to choose a direction, toxic chemicals, sickness - choice - life, healthy life.”* - I don't want to come in the rest of my life! *“I don't want you to either, I couldn't handle that. You set a goal and now I'm going to help you fulfill that goal. Now let's get to work.”* ## Training practice: New Patients You are in proximity with someone that is limping or holding their neck etc. what do you say? I noticed you were limping, what's going on with that? Would you mind if I were to explain how chiropractic might be able to help that? **You are standing in the waiting room and someone you don't know walks in, what do you do?** “Hi I'm Dr. ______ can I help you?” Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. Vaccination, pain-normalization, blame and anti-medical passages are archival, not approved templates. ### care-referral-capture · Companion, improvement, lecture and direct-referral scripts Sources: IMG_0333 **A friend of a patient comes in with the patient. What do you do?** “Hi I'm Dr. ____ are you with _____? Have you ever been to a chiropractor before? Was it a good or bad experience? Let me show you what we are doing with your friend, come over here I'll show you. (show posters, talk about curves, examine them, take x-ray set up ROF) **At a party you want to let others know that you are a chiropractor, how do you turn the conversation toward chiropractic?** “What is it that you do?” Then when they ask you what you do tell them you are a chiropractor. “Have you ever been to a chiropractor before? Was it a good or bad experience?” **A patient lets you know that their symptoms are improving. What do you say?** “Awesome, isn't that amazing how the body can heal itself once the pressure is gone? Who do you know that has _____ that I can help?” **Your patient is a FAN and you want to set up a lecture. What do you say?** “Mary I don't know if you know what are mission is, but it is to HELP AS MANY PEOPLE AS HUMANLY POSSIBLE. Who is your enrichment leader, or Where do you work, or What groups do you belong to? We go out in the community and educate groups on _____ _____ _____ **What question do you ask in order to open conversation toward referrals?** “John how do you explain to others what we do in our office?” **Asking for direct referrals what do you say?** - “Who do you know that has _____?” - “Would you mind if we were to try to help them?” - “What we found works the best is for the doctor to give them a call then I can answer their questions over the phone. Give the name and number to my receptionist, and then tell your friend that I will be calling them in the next day or two.” - Walk the patient up to the receptionist and say, “Claire _____ has a friend that has (symptoms) and she is going to give you her name and address so I can call her and offer her a no-cost evaluation.” Notes: Obtain permission for sharing information and contact. Keep next-day-or-two physician call commitment only when assignable. ### care-orientation-report · Group doctor-report outline Sources: IMG_0334 # I am able to perform an effective orientation, and Report of Findings. (**Chapter 10**) ## Doctor’s Report Outline ### ***Opening*** 1. Thank you for coming here tonight. I realize your time is valuable. 2. This will be a different experience for most of you. We will be going over several x-rays to help you understand how to read x-rays. These are not yours. When we are through looking at these, we will then go into a private room and look at yours. You then will be able to tell me what is right and wrong with your own x-rays. 3. At that point we will show you how we make it affordable for everyone here to have it corrected, if that’s what you choose. 4. So we can quickly go through this information without any interruptions, please turn off any cell phones or pagers. Draw a line from top to bottom on the white board on top #1 and bottom worst. Where do we rank. Have stats to read about how we rank. Top 3 causes of death in the US. ### ***Body*** 1. Destroy their faith in the current medical system. (**56th in health, take 75% of all drugs, spend more on health care than the next 10 countries combined. 2 plus 2 isn’t 4, why?**) (**If you had a race car and spent 10 times more money on it than anyone else and got last place, wouldn’t you be upset?**) 2. Explain the role of the CNS (both posters) and how all body functions are controlled from above-down-inside-out. (**Brain – body – function – ease**) 3. What would happen if we were to interfere with the brain talking to the body? We call that a subluxation. (**Brain – body – Malfunction – disease – symptoms**) 4. All doctors understand this and there is no misunderstanding until we get to here (symptoms). Medical doctors look for a drug to get your body to get back in balance, and chiropractors look for the reason the symptom is there in the first place. 5. Years ago the Rockafellers and the Carnegies started the pharmaceutical companies and went to the American Medical Association and said if you push these drugs we make, we will make you one of the most powerful organizations in the world. They all agreed except for 5 medical schools. Those 5 all went out of business. The drug companies and medical association tried to destroy any profession that taught anything besides drugs and surgery. 6. How do you know when it is better to remove the pressure or take a drug? (**rock in shoe, if the drug wears off and the symptoms come back then it is physical pressure causing the problem.**) 7. To get a mis-allignment you must have a trauma. This is what subluxations look like. (**show and explain pre and post x-rays**) 8. To change the spine back to normal. Do you think I can do it in a week? (**it will take on the average 3 months to 1 year depending on the damage**) 9. Once we get it corrected, what do you think the best thing to do is? (**keep it there with maintenance adjustments**) ### ***Ending*** Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. Historical statistics, conspiracy/history assertions, broad clinical claims and “destroy faith” rhetoric require review; preserve only as source reference. ### care-private-rof · Private ROF questions, commitment and finance handoff Sources: IMG_0335 1. Finish with a **compelling story** full of passion. (This is why I expect every person and child should get checked. I don’t want this to happen to anyone’s child. So if you want your subluxations removed I expect to see your children, and I will even pay for their evaluation) 2. **Take the couple that arrived first, back to see their films,** *(with a financial person so she/he can hear the responses to the questions).* *(films should be up and go through the questions)* ***Questions*** 1. What do you see? 2. What is it doing to your spinal cord and nerves? 3. What would happen if you left it alone? 4. On a scale of 1-10, 10 being the most committed, where are you at in getting it corrected? (if less than a 10, then why?)(to make most of the changes in your spine, you will need to be seen 3 times a week for 90 days, at which time if the changes are occurring as planned you will be cut down to 2 times a week and then 1 time a week. But I expect it will take about _____ visits to get you close to maintenance.) 5. If a 10 then say, “Great, ______ will show you how we make it affordable for you, and then I will adjust you when you are finished.” [if less than a “10” common reasons are: 1. It depends on the cost. (if we can make it affordable for you, is there anything else stopping you from being a 10?) 2. I don’t know if I can make it here 3 times a week. (if we can work out a schedule for you, is there anything else that would stop you from being a 10?)] Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-pgc-partner-letter · PGC business partner letter and redemption call Sources: IMG_0338 ### (Sample letter from a business for a PGC) Dear _____ Thank you for meeting with me today, and allowing me to explain how we would like to help your business. Willow Creek Chiropractic has been operating business in Sandy now for 30 years, and as a way to give back to the community which Dr. Thomas loves, he wants to give you some BODYWORK GIFT CARDS. These cards can be handed out by your staff when a client signs up for your Diamond services saying something like, “As a special gift for you we are giving you a Bodywork Gift Card loaded with several services and a 30 minute massage for purchasing our Diamond Package. Just give them a call whenever you’re ready, we have taken care of all expenses for you. Enjoy.” A gift like this is completely unexpected and appreciated. All we need is the name and phone number to call them and let them know of times we have available if they don’t call us in a reasonable time frame. When we call them we will say something like this; “Mary this is _____ from Island Bodyworks and Willow Creek Chiropractic, and I understand that PLANET FITNESS has given you a gift card loaded with services, and I am calling to find a good time for you to redeem your services, is morning or afternoon better.” The most common comments we receive are: “I can’t believe they would do that, that is so nice of them.” There is no cost to Planet Fitness, this is just our way of giving back to the community and we are glad you want to help us out. 4 Notes: Full user-provided sample letter. Replace historical brand, tenure, offer and partner only with verified current facts; establish lawful permission to transfer/contact recipients. ### care-marketing-booking · Marketing appointment selection and directions Sources: IMG_0339 Primary Script 1. Find a health problem they want gone. 2. Ask questions about it and how it is affecting their life. 3. Teach how we might be able to get rid of it permanently. 4. Make the appointment. Making an appointment 1. Is morning or afternoon better? 2. Is ______ or ______ better? (choose the next 2 mornings or afternoons available) 3. Is ______ or ______ better? (choose 2 times in that morning or afternoon) 4. Give directions. 5. “Now because the doctor will be blocking off his time to meet with you, is there any reason you wouldn’t be able to keep that appointment?” Giving directions Always have them enter in off Highland drive, going up the south ramp. There they can see and follow the blue signs into the office. If they come in on the north side (Creek Road) they will not be able to find the correct building. Notes: Directions are historical; use verified current office address/directions later. ### care-marketing-explanation · Marketing philosophy and benchmark reference Sources: IMG_0344 ## 1st Understand how chiropractic works and why we are different than medical doctors and other chiropractors. Chiropractic has only one goal – to remove any pressure on any nerve. As we go throughout life there are many opportunities to have trauma. This trauma can move a bone out of it’s original position and now put pressure on the delicate nerves around them. This nerve pressure will interfere with the signal that is trying to get to the brain from the tissue or the signal that is trying to get to the tissue from the brain. These signals getting to their target are crucial to sustain life. Interference along the nerve path will cause a malfunction. That is where chiropractors come in. We are trained to locate the interference and correct the bone position in a gentle, pain free, way. This allows the body to get back to the way it was originally designed to work. A Medical doctor does something completely different. They focus on the symptoms and try everything they can to get rid of symptoms. We don’t agree with that, we feel the symptoms are they way the body is telling you something is wrong. Just like an oil light in you car tells you something is wrong. Putting tape over the light will not fix your engine. The light or symptom is just there to tell you something is wrong. We don’t try to hide the light but use it as only one of the tools to discover what is really wrong. By removing any interference, allows the body work again. That is why you will hear so many testimonials, from not only pain relief, but diabetes, deafness, blindness, diseases clearing up, autoimmune diseases going away, colic babies now sleeping again, and just about any disease you can think of. If there is nerve pressure, we can help. If there is nerve pressure, there is nothing any medical doctor can do about it. Chiropractors also realize that eating, knowing how to handle stress properly, and exercising properly is important too. So, we offer classes in the office and in businesses to promote good health and improve our community. Chiropractic treatment is considered the most **cost effective and safest treatment** is the world. *With* chiropractic care being so good and inexpensive, everyone should be going to a chiropractor. But there is a problem. The medical association (American Medical Association) has felt very threatened by a profession that actually cures sickness instead of hiding the symptoms of the sickness. And has done everything possible to turn people away from trying chiropractic in an effort to keep the population to themselves. Even though the chiropractors sewed them (Wilk vs. AMA) and they were found guilty of trying to “eliminate their competition for financial gain.” They still do not work with chiropractors. So, we have a population that desperately needs us, but are constantly being told by their health care providers to not seek help from us. This is how we handle that situation. We talk to people either one on one or in groups and teach them the primary script. This script is so simple, yet powerful in getting a prospective patient to consider alternative treatment. There are unlimited ways of getting names and numbers of people near our community, and then call them using the primary script. You will know you are amazing with the script when you can get 70% of the people you talk to, to come in and get their no-cost evaluation. 11 Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. Review-only disease/medical claims; author conversion benchmark is not a forecast. ### care-donation-meeting · Five-minute business donation meeting invitation Sources: IMG_0345 - You could call businesses line up a 5 minute meeting for the doctor to make a donation with their company. Talking to the HR person of the company, *“Hello, this is ______ calling from Dr. ______ office. He/she would like to make a donation to your company and asked me to call and set up a 5 minute meeting with you to go over his/her donation. Is morning or afternoon best?”* (What is the donation? I don’t know he/she just asked me to call. Is morning or afternoon best?) Notes: Source nonprofit/donation statements must be verified; do not claim ignorance about an offer as a deceptive tactic. ### care-pain-and-visit-steps · Pain response and standard four-step adjustment dialogue Sources: IMG_0297 **The adjustment hurt, what do you say?** There was a lot of scar tissue around that joint. Now we finally got movement and it can begin to heal. Put some ice on it and I will check you on _____. (make sure the next adjustment is close to stay right on top of it.) Then don’t hurt them again. **What is your objective for the patient’s first week of care?** To have them think you are the most amazing person on the planet. No one cares as much as you, no one has better hands than you, no one coaches and directs them as much as you. **If the patient doesn’t think you are anything special, what are you going to do about it?** Find out exactly what they want and give it to them. **Where can you find out what they want out of you?** Consultation, Travel card or special consultation. **What are the main steps to the adjustment?** 1. Greet them lying face down by name. “Mary it is good to see you, let’s check you.” 2. Deliver a specific adjustment while teaching them what you are doing and what you found (good or bad) 3. Give them specific instructions. (change of calendar, rehab, home care...) 4. Tell them when you will see them again. (See you Wednesday) If you confidently tell the patient what to do, what you like, what you don’t like, what you expect from them, what will happen? They follow. Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. Scar-tissue reassurance is source text only, pending clinician review. ### care-exam-findings-explanation · Exam findings explanation and imaging preparation Sources: IMG_0302 - **Palpate the spine, when you find something pause, push a bit harder and say “There it is. That is what is causing ....” Or “This goes to your....”** (Tie into their symptom if you can) (MDs don’t touch – this is powerful) - **Show on the posters what you have found and tie together their symptoms and the level of subluxation on the poster and the organs that will be involved.** - **Explain what x-rays are needed to confirm what you have found.** - **Explain the costs.** - **Say the script... “Tonight I am going to spend........”** - *“If working with Enrollment, use the script about the spouse or significant other.”* **4. The X-rays** - Take the patient in the x-ray room - Take x-rays - Mark the travel card with any x-rays taken, exam done, fees incurred. - Do Script Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-focused-visit-handoff · Focused adjustment greeting and special-consultation handoff Sources: IMG_0322 **1-2 minute** The patient’s first adjustment needs to be under a minute, as they will be judging the expected length of each adjustment to be based on this first visit. The following will help to make sure each visit is under two minutes. - *Arrive focused.* - The patient is shown the flow. - The patient is laying face down when you get to their table. - Touch them and say “Good to see you _____. Let’s check you.” - **1 minute ROF** (Teach them what you are finding (good/bad). Teach them something new about health). - Exit – **“The power is on. Check you Wednesday!”** (*Turn and walk to the other table*) - Stay focused and keep the conversation on what they are paying us for. Be friendly but not friends. - When you notice something is not going right or they have more questions than what can be answered in a short time, then tell the patient “That is a good question, and I want to answer that. “Would you talk to the receptionist and have her set up a special consultation where you and I can sit down for a minute?” Notes: Only a licensed clinician may assess symptoms, select treatment, imaging, rehabilitation, frequency or referral. Source claims and scripts require review before patient-facing use; software proposes tasks and captures clinician decisions, not clinical orders. ### care-new-patient-thanks · New patient welcome and appreciation Sources: IMG_0328 # NEW PATIENT - Hello, I'm Dr. ________. Thank you for choosing our office, we know you have a choice. Notes: Exact source passage, including stage directions. Historical names, location and prices are not current configuration. ### grow-primary · Primary Script — complete prospect and referral version Sources: IMG_0349 **Primary Script** **Question #1 - Do you have any health problems that concern you?** **Question #2 - If you get a NO to this question then ask this question, “Is there anything about your health that you would like to change like energy, weight, sleep?”** Yes **Do you mind if I ask you what it is?** *I have headaches, seizures, diabetes, foot pain, and stomach problems.* **Which one of those concerns you the most?** *My foot* **Why is that?** (or what’s up with that, or why does that concern you, broad general questions at first work the best) **Oh, I am sorry to hear that.** (get them talking so you can get them to a point they can’t keep going on like this.) Sample questions are” How long have you had those? What have you done to get rid of it? How did that work for you? When it is as it's worse what is it like? How does that affect you at work? How does that affect you with your family? Do you have any hobbies? How does it affect you there? How old did you think a person should be when they start having problems like this? So it makes you feel ____ year older? [When you feel they are painfully aware of how terrible their condition is and want to get rid of it then go to the next question] **Would you mind if I were to tell you how chiropractic might be able to get rid of it permanently?** *Sure* **Chiropractic works with physical pressure on nerves, like having a rock in your shoe. Have you ever had a rock in your shoe?** Yes **How did it feel?** *It hurt* **Yes it hurt because it was putting pressure on a nerve in your foot. There are nerves in your ____ that go to your ____. Sometimes the bone can get knocked out of place and puts pressure on the nerve. Just like the rock in your shoe was putting pressure on the nerves in your foot, bones putting pressure on a nerve can cause the same thing. I don’t know if you have this physical pressure causing your ____, but I think it would be worth a shot to find out, don’t you?** Yes **I don’t think it should cost you to find out, I can set you up for a no-cost evaluation. Would morning or afternoon be better.** *If the person answers NO to the first 2 questions, then let them know they don’t qualify, quickly explain the rock in the shoe and say, “I know you said you don’t have any health problems but is there someone you know you want to gift this to?* *If they know of someone, ask them about the other person’s symptoms, exploring those symptoms and get the name and number of that person.* *If they don’t give you a name then say, “Great thank you so much, have a great day.” Move on! This is a valuable gift. If they don’t want it, it is their loss. Don’t beg and beg and sweeten it by offering stuff.* 16 Notes: ['Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation.', 'Full historical source retained; printed page 16 retained as provenance. Alternate version uses “help” instead of permanent relief.'] ### grow-primary-alt · Primary Script — alternate telephone version Sources: IMG_0366 **Primary Script** **Do you have any health problems that concern you?** If you get a NO to this question then ask this question, “Is there anything about your health that you would like to change like energy, weight, sleep?” Yes **Do you mind if I ask you what it is?** I have headaches. **Oh, I am sorry to hear that.** (get them talking so you can get them to a point the can’t keep going on like this.) Sample questions are” How long have you had those? When it is as it's worse what is it like? How does that affect you at work? How does that affect you with your family? Do you have any hobbies? How does it affect you there? How old did you think a person should be when they start having problems like this? So it makes you feel ___ year older? [When you get to ruin then go to the next question] **Would you mind if I were to tell you how chiropractic might be able to help you?** Sure **Chiropractic works with physical pressure, like having a rock in your shoe. Have you ever had a rock in your shoe?** Yes **How did it feel?** It hurt **Yes it hurt because it was putting pressure on a nerve in your foot. There are nerves in your ___ that go to your ___.** **Sometimes the bone can get knocked out of place and put pressure on the nerve. Just like the rock putting pressure on your foot, bones putting pressure on a nerve can cause the same thing. I don’t know if you have this physical pressure causing your ___, but I think it would be worth a shot to find out, don’t you?** Yes **I don’t think it should cost you to find out, I can set you up for a no-cost evaluation. Would morning or afternoon be better.** Notes: ['Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation.', 'Preserves author typos including “the can’t” and “ruin”; no polished copy has been substituted.'] ### grow-survey-call · Stress survey callback Sources: IMG_0364 ### Calling stress surveys: “Hi ___ this is _____ calling from Dr. Thomas’ office. You filled out a stress survey at ____ and I have a question, you mentioned that you had ____ ____ ____ which one of these concern you the most? ....(get them talking about their symptoms and do the primary script, then make the appointment. Responses will fall in 2 main categories: 1. They don’t have any symptoms they want to get rid of. And there is nothing in their life like weight, sleep or energy that they want to change. “Thank you for your time and have a great day.” 2. They have things in their life they want to change. Proceed with the primary script Notes: ['Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation.', 'Includes no-symptom branch. Similar shorter version on IMG 0350.'] ### grow-pgc-handout · Public Gift Certificate handout — both variants and objections Sources: IMG_0351 ## Handing out a PGC Go where people are, with PGCs and 3x5 card to get their name and number. Excuse me do you live or work around here? (Everyone wants to help someone that is lost) (Hand them the card) “Here, this is for you. It’s a bodyworks package including a massage. Do you like massage? Do you want one?” When they say YES, then take the card back and write on the back your initials or something that will identify it was you. “OK, let me go ahead and activate that for you.” Hand it back. “There you go, just call the number on the back and they will set you up.” With the 3x5 card. “Now what was your first name? And does your number begin with 801 or 435?” After they tell you, repeat what they said and just pause, keep looking down, and they will give you the rest. OR “Hi, do you live or work here in ___? (with hand beside you).” Yes – Place it in their space. “Here this is for you.” If they don’t want it - “No problem, have a great day” “It’s a free bodyworks package including a massage. Do you like massages?” Yes. “Here let me activate that for you.” Take the card back, putting your initials on it then give it back to them. With a 3x5 card write down their first name and number by saying, “What’s your first name?” “And does your number start with 801 or 435?” (pause and let them tell you the rest of the number. Write their first name and number on a small pad) “You can just call this number to schedule your appointment. And if I haven’t heard from you in a couple days. I’ll just give you a JINGLE to let you know what times we have available.” “Have a great day.” ### Trouble shooting: I don’t want to give you my number - “Oh this is just for me to be able to let you know what times are available. Would that be OK with you?” What’s that catch? “You only can use it once.” Why are you giving this away? - “We call it advertising through touch. If you like us, you will use us again.” 18 Notes: ['Referral contact supplied by someone else is not recipient consent. Proposed contact eligibility and refusal/suppression controls require approved policy; do not expose patient health details publicly. Advertised scarcity and value must be factual.', 'Original area codes and issuer details are historical placeholders to replace only in an approved working version.'] ### grow-pgc-call · Public Gift Certificate booking and package explanation Sources: IMG_0352 # Calling on a PGC “Hi ____ this is ____ calling from Island Body Works and Willow Creek Chiropractic. You received a gift card for a COMPLIMENTARY BODY WORKS PACKAGE AND A MASSAGE from ____________ and I am calling to let you know what times we have available. Is morning or afternoon better for you?” (Set the appointment) “Because this is a therapeutic massage, do you have any health problems that concern you?” Do Primary script. Let me tell you how this goes. Your Body Works Package is done over a couple days. The first day you will meet with the doctor and he will do a full evaluation to find out what is causing your _____. On the second day he will report to you his findings and you will be set up for your therapeutic massage. Do you have any questions? Give directions. “I look forward to seeing you on ____ at _____. I hope the doctor can help you with your _____. See you then.” 19 Notes: ['Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation.', 'Historical fees, discounts, free services and donation offers are source examples, not approved current terms. Review actual pricing, eligibility, payer rules and consent before use; no automatic charging or pressure for financial disclosure.'] ### grow-pgc-call-30 · PGC call — thirty-minute massage variant Sources: IMG_0367 ## Calling on a PGC Hi ___ this is ___ calling from Island Body Works and Willow Creek Chiropractic. You received one of our Certificates for a **_COMPLIMENTARY BODY WORKS PACKAGE AND A 30 MINUTE MASSAGE_** and I am calling to let you know what times we have available. Because this is a therapeutic massage do you have any health problems that concern you? Do Primary script and make the appointment. Let me tell you how this goes. Your Body Works Package is done over a couple days. The first day you will meet with the doctor and he will do a full evaluation to find out what is causing your _____. On the second day he will report to you his findings and you will receive your specific therapeutic massage. Do you have any questions? Give directions. I look forward to seeing you on ____ at _____. I hope the doctor can help you with your _____. See you then. Notes: ['Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation.', 'Variant offers 30 minute massage and describes second-day massage delivery.'] ### grow-business-intro · Business/community opportunity discovery Sources: IMG_0369 ***Does your company take an active interest in your well-being? What do they do?*** Notes: ['Only the exact provided question; no full business outreach script is supplied in these pages.'] ### grow-dinner-offer · Dinner referral and guest offer Sources: IMG_0375 Spring back to health is where we have created 20 slots for our patients to bring in their family and friends. There are only 20 spots available so wrote down on that 3x5 card people you would like us to extend the offer to. For a 17 dollar donation to Shelter Kids they will receive exam, x-rays and first adjustment. Those of you who are guests are probably wondering if you have spinal problems that are causing health problems. For coming here tonight we are offering you the same thing. Before leaving tonight schedule with Debra for tomorrow or Friday. Notes: ['Historical fees, discounts, free services and donation offers are source examples, not approved current terms. Review actual pricing, eligibility, payer rules and consent before use; no automatic charging or pressure for financial disclosure.', 'Referral contact supplied by someone else is not recipient consent. Proposed contact eligibility and refusal/suppression controls require approved policy; do not expose patient health details publicly. Advertised scarcity and value must be factual.', 'Original charity,20 slots,$17 and tomorrow/Friday details are examples needing current approval.'] ### grow-physician-letter · Handwritten doctor introduction and article note Sources: IMG_0378 1. Compile a list of the General Practitioners, Orthopedics, Neurologist, OBGYN, doctors with names and addresses, and create a mailing list. (Hand written short letter saying; “Hi Dr. _____, I’m Dr. _____ I’ve had success with _____, but sometimes I have patients that need help like yours. I’m looking for someone to send them to. If you’re interested please call me at 942-4999.) 2. Several days later the doctor makes a phone call to each one that did not respond. (Re-iterate the letter) 3. Monthly send them an article with a sticky note on it hand written with something like “Thought you might like to see this.” Notes: ['Contains exact letter example, several-day nonresponder call and monthly sticky-note wording. Current professional scope and claims must be accurate.'] ### grow-testimonial-interview · The Patient’s Story interview Sources: IMG_0371 ### The Patient’s Story: 1. Tell me what your health life was like before coming to Willow Creek Chiropractic? 2. What did you do for it? 3. How did it work? 4. How did chiropractic change your health? - Ask the patient for their permission to share their story with others and put it up on the wall in the reception room. - Write their comments down. Notes: ['Patient review and signed authorization are completed by IMG 0372 before publication.'] ### grow-referral-post-finance · Post-financial arrangement referral ask Sources: IMG_0390 1. They don’t come when a patient gets better, they refer when they BUY. At the beginning of the relationship when the excitement is hot. “Mrs. Jones, If I help you will you help me?” 2. After the financial arrangement is made now asks for referrals. (family members and others with pain that they know.) With endorsements from CA #1 on the phone and the ROF from the doctor and now your 3rd party endorsement, their hope and expectations are high, so offer a complimentary evaluation for the rest of their family and friends. The CA will also give the patient 2 certificates they can take with them to give away. Notes: ['Only quoted ask is exact source; accompanying operational instructions retained. Referral participation must be voluntary.'] ### grow-reactivation-newyear · New Year reactivation call — full continuation Sources: IMG_0380, IMG_0381 ## REACTIVATION SCRIPT **CA** – Hello, is _____ there? PT – Yes, this is _____ . **CA** – This is _____ from WCC. Do you have a minute to speak? PT – Yes I do. **CA** – The reason I am calling is to see if you received the invitation we sent you to receive a free treatment and checkup to start the year as healthy as possible. PT – Yes I did; or no I did not. **CA** – Well, let me explain what we are doing. The doctor has set aside time to help all of his former patients start the year as healthy as possible. The doctor is offering our former patients a free adjustment and stress checkup. We are doing this in order to help you feel great and bring your records up to date. In the past, your major problem was _____. How is the problem doing now? You also had a problem with _____, how is that doing? Are there any new problems? [If there are new problems or if old problems are acting up the CA asks for more details on their problems: how long and how often it bothers them.] CA – Based on the fact you are having new symptoms I would suggest you come in for this free treatment and stress check up. What day would be best for you Monday or Tuesday? (most patients schedule now) PT – I’m not interested at this time. CA – Would you mind me asking if there is any problem or upset you had with our office? PT – Yes, explains upset. (CA handles upset and then attempts to schedule patient). No, just too busy, feeling great, no need, etc. CA – Well, thank you for your time. Bye. Notes: ['Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation.', 'Continuation assembled in photo order; includes old/new symptom inquiry, upset recovery and graceful refusal ending.'] ### grow-valentine-letter · Valentine reactivation letter — full continuation Sources: IMG_0381, IMG_0382 **VALENTINES DAY REACTIVATION INVITATION (letter)** Dear We chose to send you a Valentine’s gift that would improve your health. It is an opportunity to receive a free Chiropractic Adjustment and free Stress Evaluation. Stress contributes to over 80% of all disease. I have recently taken advanced studies on how to evaluate and reduce the effects of stress on a person’s body. Such problems as fatigue, headaches, pain, sleep troubles, mood swings and digestive problems to name a few are stress related. Give yourself a gift this Valentine’s Day, call and schedule your free adjustment and stress check up. Because we care, we are making this gift available for the next 2 weeks. One of our staff will call to schedule your visit if we do not hear from you. If you don’t wish to receive this gift, please allow us to update your records over the phone. Yours for better health, P.S. Please find enclosed a gift certificate for a family member or friend to receive a free consultation or stress analysis. Notes: ['Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation.', 'Medical assertions are unverified historical source and must not be automatically sent as approved copy. Letter date/offer conditions need current approval.'] ### grow-reactivation-valentine · Valentine reactivation call — full continuation Sources: IMG_0383, IMG_0384 ## REACTIVATION SCRIPT CA – Hello, is _____ there? PT – Yes, this is _____. CA – This is _____ from WCC. Do you have a minute to speak? PT – Yes I do. CA – The reason I am calling is to see if you received the invitation we sent you to receive a free treatment and checkup to start the year as healthy as possible. PT – Yes I did; or no I did not. CA – Well, let me explain what we are doing. The doctor has set aside time to help all of his former patients start the year as healthy as possible. The doctor is offering our former patients a free adjustment and stress checkup. We are doing this in order to help you feel great and bring your records up to date. In the past, your major problem was _____. How is the problem doing now? Yu also had a problem with _____, how is that doing? Are there any new problems? [If there are new problems or if old problems are acting up the CA asks for more details on their problems: how long and how often it bothers them.] CA – Based on the fact you are having new symptoms I would suggest you come in for this free treatment and stress check up. What day would be best for you Monday or Tuesday? (most patients schedule now) (“It’s okay if you lost your certificate, I can just schedule you anyway”) PT – I’m not interested at this time. CA – Would you mind me asking if there is any problem or upset you had with our office? PT – Yes, explains upset. (CA handles upset and then attempts to schedule patient). No, just too busy, feeling great, no need, etc. CA – Well, thank you for your time. Bye. Notes: ['Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation.', 'Source itself retains New Year wording in this campaign. Typos preserved. Lost certificate explicitly does not block scheduling.'] ### grow-charity-invite · Have a Heart donation and recipient invitation Sources: IMG_0385, IMG_0386 ## INVITATION SCRIPT CA: Hi, Did you get a chance to look over the flyer regarding our Have a Heart Campaign? PT: Yes/No CA: We’re doing a Valentine’s Day Charity on Valentines Day. Can I get you to read this flyer? If you want to help – it’s up to you. (no pressure) CA: For your donation of $5-$20, we will allow you to send anyone you know a gift certificate for a free consultation stress check up and massage. Would you be willing to help these women? PT: Sure **CA: Thank you so much. How much would you be willing to donate?** [illegible]T: $10 **CA: Thank you again. Let me show you the gift certificate and card. Do you know who you would like to send this to?** **(If “NO” ask, Is there anyone you know who has arthritis (pause), headaches (pause), back or neck pains (pause), digestive troubles (pause), hormonal problems (pause, etc.** PT: Well my mom complains about arthritis. CA: Really? How long has she had it? What is it like for her when it’s bad? I would definitely give her a gift certificate. Can I get her address so we can send her this card with the certificate? PT: Sure **CA: People don’t always know what we do. Can I get her phone number to call and answer any questions she might have?** **[Have the patient sign the letter and put any special comments they would like to try to get them in.]** Notes: ['Historical fees, discounts, free services and donation offers are source examples, not approved current terms. Review actual pricing, eligibility, payer rules and consent before use; no automatic charging or pressure for financial disclosure.', 'Referral contact supplied by someone else is not recipient consent. Proposed contact eligibility and refusal/suppression controls require approved policy; do not expose patient health details publicly. Advertised scarcity and value must be factual.', 'No-pressure statement retained; final speaker label in IMG 0385 is partly obscured.'] ### grow-charity-call · Have a Heart recipient follow-up — full script Sources: IMG_0386, IMG_0387 ## FOLLOW-UP PHONE SCRIPT **Hello is this Mary?** **Mary, this is _____ from Dr. Thomas’** **Your (sister, friend, etc) Jane Smith recently sent you a gift certificate. As a courtesy to her we have taken time today to call you and explain what the gift certificate covers.** **It covers a consultation and screening to discover not only the cause of your problem but also possible natural solutions. In addition you get a brief trigger point massage.** The consultation is extremely thorough and will find out what you have done to cause your body to break down, so we can determine what needs to be done to repair it. The screening involves a few tests to determine what form of treatment would work the best to solve your problem. Other doctors in our community charge between $150 and $300 for the time we spend with you but there is no charge to you. Our purpose is to help as many people as possible with natural safe alternative health care and want you to find out if these methods might help you. The appointment takes 45 minutes and I want to find out if you prefer a morning, afternoon or evening appointment? [If they choose only for themselves add this:] The doctor also wanted me to extend this opportunity to anyone else in your family. Is there anyone else you would like to bring with you at that time? Notes: ['Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation.', 'Historical fees, discounts, free services and donation offers are source examples, not approved current terms. Review actual pricing, eligibility, payer rules and consent before use; no automatic charging or pressure for financial disclosure.', 'Includes 45 minute duration and optional family extension.'] ### grow-family-invite · Family Day clipboard, history and tentative-booking conversation Sources: IMG_0388, IMG_0389 ## SCRIPT How are you feeling today? **(fine)** That’s great. I wanted you to know we are celebrating family health this week and I wanted to give you this flyer to read regarding a special program we are doing and bring it back when you are done. **(hand flyer and clipboard to patient)** **(patient returns clipboard)** Before you sit down, can I just look at your family history form and ask you a few questions? Which of these people live locally? **(yes)** Who? Are there are any of these family members you would like us to evaluate? We only have 15 openings, we will probably be full today, what I suggest is we make a tentative appointment for them. Make appointments and ask them to fill out the referral envelope so you can mail the letter to their referral or if they prefer give it to give them in person. Ask for their phone number so you can call and give directions. Notes: ['Referral contact supplied by someone else is not recipient consent. Proposed contact eligibility and refusal/suppression controls require approved policy; do not expose patient health details publicly. Advertised scarcity and value must be factual.', 'Actual availability must support 15-openings claim. Tentative third-party booking requires recipient acceptance.'] ### grow-family-call · Family Health Week follow-up — full continuation Sources: IMG_0389, IMG_0390 ## FOLLOW-UP PHONE SCRIPT Hello is this Mary? Mary, this is _____ from Dr. Thomas’ Your (sister, friend, etc) Jane Smith recently sent you a letter about out Family Health Week. As a courtesy to (him/her) we have taken time today to call you and explain what the gift certificate covers. It covers a consultation and screening to discover not only the cause of your problem but also possible natural solutions. In addition you get a brief trigger point massage. The consultation is extremely thorough and will find out what you have done to cause your body to break down, so we can determine what needs to be done to repair it. The screening involves a few tests to determine what form of treatment would work the best to solve your problem. Other doctors in our community charge between $150 and $300 for the time we spend with you but there is no charge to you. Our purpose is to help as many people as possible with natural safe alternative health care and want you to find out if these methods might help you. [Hand-drawn curved bracket] The appointment takes 45 minutes and I want to find out if you prefer a morning, afternoon or evening appointment? [If they choose only for themselves add this:] The doctor also wanted me to extend this opportunity to anyone else in your family. Is there anyone else you would like to bring with you at that time? Notes: ['Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation.', 'Historical fees, discounts, free services and donation offers are source examples, not approved current terms. Review actual pricing, eligibility, payer rules and consent before use; no automatic charging or pressure for financial disclosure.', 'Hand-drawn bracket annotation retained from source transcription; no added words.'] ### grow-finance · Financial arrangement: full cost, one-time, monthly and affordability Sources: IMG_0359 **CHAPTER 6** # Create financial arrangements - When You will be sitting with a patient to go over the doctor’s recommendations and working out how the patient is going to be able to pay for this care in the following situations: 1. After their report of findings (ROF). 2. At the end of their care plan, to create a new one. 3. Room 4s that can happen any time. ## Creating a FINANCIAL ARRANGMENT *(Sit beside the patient and go over the paperwork. Don’t put it between you.)* ### Corrective Care Plan Sheet: “To make most of the corrections based on clinical experience it will take ___ visits to get you to a maintenance basis.” Go over Corrective Care Plan sheet and show how you came up with that number and the other numbers. “Do you see where we come up with the ___ visits?” ### Patient Financial Summary sheet: #### First go for a ONE-TIME PAYMENT: “So the total is _____. Now let me show you how we make it even more affordable. When you make a one-time payment, it saves us on bookkeeping so we pass the savings right back to you. That is 20%. Let me see, the one-time payment would be _____. And that would save you _____ dollars. Wow, that’s almost _____ dollars in savings. How would you like to take care of that? *(Exhaust all sources of money before going to Monthly Payments.)* #### Second go for MONTHLY PAYMENTS: (Draw a line through the one-time payment option) “Another option is we can break this up into monthly payments. You don’t get a discount, but it allows us to spread it out evenly over several months. How much can you put down? Now let’s see if we spread the balance over 6 months that would be $___ each month. Can you handle that?” (If not, then extend the months to lower the payment. We can take a credit card on file or post dated checks.) #### Third see if they have money or not If they say they cannot afford either of the above options then ask: “Tell me, what’s going on with your finances?” If they start to tell you then keep asking questions until you get a clear picture of their financial situation. Then you will know how what you have to work with. This would be the time to do a modified plan. If they tell you that they can’t afford it, then ask them again “Now you are working right? What’s going on with the finances?” If they still don’t want to give the details then they are really saying they have the money they are not sure if they want to spend it with us, they don’t feel confident that we can really do what we say we can, or want to test us out Notes: ['Historical fees, discounts, free services and donation offers are source examples, not approved current terms. Review actual pricing, eligibility, payer rules and consent before use; no automatic charging or pressure for financial disclosure.', 'Ends mid-sentence; continued in modified-plan/trial script.'] ### grow-finance-modified · Modified financial plan and three-visit trial Sources: IMG_0360 first, or they are only interested in relief type care. In this case go for the **3 visits**. This gives the doctor 3 visits (week, month) to try to win them over. If at the end of the 3 visits (week, month) he has won them over then you can sit with them again to work out a longer financial plan. If he did not win them over, then we gave it our best shot. These visits are paid for visit by visit at the regular fee. MODIFIED PLAN: **“How much can you put down?”** **“What can you afford on a monthly basis?”** Multiply that number by 12 for 12 months. Add the down payment and the total monthly payments and this will give you the yearly amount they can pay. Up-front　　　　　　　　　　　　　　　　$200 Monthly　　　　　$100 times 12 months = $1200 Add to get total　　　　　　　　　　　　 = $1400 Divide $55 (cost of each visit) into $1400. This will give this individual 25 adjustments to be used throughout the year, assuming their finances don’t change. This is not the ideal situation but it allows the patient to begin right away getting results and starting their care. I would rather get a patient starting their care right away then wait until they have all of the money. Many will find new money during the year from getting in a car accident, work related injury, Christmas money, home equity loan, family, change of jobs, change insurance etc. Exams will be at no-cost, x-rays are $30 a piece, and rehab will be at no-cost. Have them double the amount of time spent on home exercises from 15 minutes AM and PM to 30 minutes AM and PM. 3 VISITS / Dr. Thomas **“I WANT TO GO HOME AND THINK ABOUT IT.”** Acknowledge - “I don’t blame you for wanting to go home and think about it. What is it that is holding you back or want to think about?” If the decision makers are present then there is really nothing to go home and think about, and if there is then the answers are really there in the room, so talk about it here. **“I can’t afford it.”** In this case ask the question “Tell me about your finances.” As stated above, If they aren’t sharing then they have money they aren’t set on spending it here so go for the 3 visits. IF they do share then do the Modified Plan. Whether they want to go home and think about it or they say they can’t afford it and won’t tell you their money situation, both of them are excuses for backing out, so offer them to test drive us and see if they will allow us to do **3 visits** and then they can decide if we are doing what we say we will do. If they like it then after 3 visits if they want to continue then we will work something out with them. If nothing can be worked out and it looks like there is nothing else you can do, then this is when you go get Dr. Thomas and you say **“OK, let me see if Dr. Thomas has any other questions..”** **We always start with showing them the care plan and the financial page regardless of the plan that gets chosen. They must have a reality check on what the plan is going to cost, then work your way down the 4 options. Trying to do a payment plan of some kind without knowing the cost of the doctor’s recommendations will always end in disaster.** Notes: ['Historical fees, discounts, free services and donation offers are source examples, not approved current terms. Review actual pricing, eligibility, payer rules and consent before use; no automatic charging or pressure for financial disclosure.', 'Includes clinical exercise directives as historical source, requiring clinician decision; no automated exercise change.'] ### grow-phone-message · Telephone message-taking and emergency handoff Sources: IMG_0362 ## *Taking a message:* Ask the two following questions. 1. “Whom may I say is calling?” 2. “And what is this regarding?” Now you will have sufficient information to make a decision whether or not to interrupt someone. “He/she is with patients right now I will give him/her the message, thank you.” [If it is an emergency put them on hold and get the person.] Notes: ['Identity/reason, recipient-with-patient response and emergency get-person rule retained.'] ### grow-new-patient-phone · New-patient appointment booking call Sources: IMG_0362 ## *NEW PATIENT PHONE PROCEDURE:* CA - *“Hello, it's another GREAT day at Willow Creek Chiropractic, this is _____ I can help you.”* PT – I need to make an appointment. CA – *“When was the last time you were in our office?”* PT – I've never been in your office before. CA – *“Is this appointment for you or your entire family?”* PT – For me. CA – *“What is your name? And your phone number?”* John Doe. 555-5555 CA – *“Is morning or afternoon better for you?”* PT - morning CA – *(state next 2 available time slots) “We can go Wednesday or Friday, which works better for you?”* PT – This afternoon. CA – *“We have an opening at 8 or 9, which works better for you.”* PT – 8 CA – *“How did you hear about our office?”* PT – Mary Jones CA – *“Great, we’ll make sure to thank her on her next visit. Let me give you directions to our office. Where would you be coming from?”* >>>>> CA - *“Now John is this visit regarding an automobile accident or a work related injury?”* (If so then you’ll be using additional paperwork when they arrive.) *“And if you have any insurance be sure to bring that information with you and we will be happy to do a complimentary benefits check when you arrive.”* CA – *“Looking forward to meeting you John. Thank you for calling.”* Notes: ['Historical fees, discounts, free services and donation offers are source examples, not approved current terms. Review actual pricing, eligibility, payer rules and consent before use; no automatic charging or pressure for financial disclosure.', 'Historical clinic greeting and slot examples retained; live working copy would insert current truthful details.'] ### grow-price-inquiry · Repeated telephone price questions Sources: IMG_0366 **Fees are never discussed on the phone.** How much is an adjustment? **“There is no cost to meet with the doctor to see if we can help you. Would morning or afternoon work best for you?”** But how much do you charge for an adjustment? **“The costs are different for everyone but the consultation is free. I want you to feel certain that once the doctor has discovered what must be done, he will discuss with you fees before doing anything. Is morning or afternoon better for you?”** I just want to know how much an adjustment is. **“What are you used to paying? We can work with that, is morning or afternoon better?”** (be sure to give this information to enrollment when they arrive and the doctor will decide what to do with it when he discusses fees.) Notes: ['Historical fees, discounts, free services and donation offers are source examples, not approved current terms. Review actual pricing, eligibility, payer rules and consent before use; no automatic charging or pressure for financial disclosure.', 'Source avoids specific quote and promises doctor discusses costs before service; do not silently turn this into current pricing policy.'] ### grow-day1-reminder · New-patient reminder — live and voicemail Sources: IMG_0367 ## Reminder calls: NP Call the night before or early enough for them to make changes to their schedule, if necessary. You get a hold of them: “Hi _____ this is _____ from Willow Creek Chiropractic. We have you down for _____, and I was wondering if you needed directions?” You don’t get a hold of them and have to leave a message: “Hi _____ this is _____ from Willow Creek Chiropractic. We have you down for _____, and I was wondering if you needed directions? Give me a call at 801.942.4999 if you have any questions, otherwise we look forward to seeing you at ______.” Notes: ['Original clinic name/phone retained as source only; working template needs current office details and privacy rules.'] ### grow-early-stage-calls · Day 1/2/3 confirmation and missed-appointment calls Sources: IMG_0361 # Chapter 4 # Phones ### Day 1 **Confirming a Day 1 appointment:** *“John this is _____ from Willow Creek Chiropractic. We are excited to see you this afternoon at 3 pm, I was wondering, do you need any directions?”* At this point you will discover if they were planning on keeping their appointment or not. If they didn’t remember or are trying to cancel, then do the Primary Script to re-kindle their desire to get rid of their health concerns. **Calling a missed Day 1 appointment:** *“John this is _____ from Willow Creek Chiropractic. We missed you today, is everything alright?”* If they reschedule or don’t reschedule, either way make sure to do the primary script again to recreate a desire to get rid of an unwanted condition. ### Day 2 **Confirming a Day 2 appointment:** *“John this is _____ from Willow Creek Chiropractic. The doctor is prepared to go over his findings with you and your wife Jill at 12 noon on Friday. Please arrive a couple minutes early and write down any questions you may have. We want to make sure we address each concern.”* At this point you will discover if they were planning on attending or not. A reschedule may be necessary if the spouse is unable to attend. If they aren’t planning on attending them let them know that the doctor found something on their x-rays that he is concerned about and wanted me to make sure you see it as soon as possible. Would morning or afternoon work best for you? **Calling a missed Day 2 appointment:** *“John this is _____ from Willow Creek Chiropractic. The doctor was prepared to go over your x-rays at noon today, is everything alright? He found something on your x-rays he is concerned about and asked me to reschedule your appointment as soon as possible. Is morning or afternoon better?”* ### Day 3 Usually there is no confirmation call. Use your judgment here. **Calling a missed Day 3 appointment:** *“John this is _____ from Willow Creek Chiropractic. I had you scheduled to come in the office today. How is everything going?”* If they have missed their Day 3 then most of the time it has to do with the finances. Re-commit them to getting rid of their health concerns and that we will make it work out for them if they really want to get rid of it. Find out the reason they are backing out and fix it fast. It is always easier to deal with the finances in person and not over the phone. Notes: ['Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation.', 'Day 2 concerning-xray claim may only be used when clinician has actually confirmed it. Source says Day 3 usually no confirmation call.'] ### grow-missed-care · Missed-care appointment, voicemail, release-exam and booking scripts Sources: IMG_0363 ### *Missed appointments are called within 20 minutes* When someone answers, assume it’s them. 1. “Hi (name) we had you scheduled 20 minutes ago. Are you on your way?” Patient responds - “Yes”, you say, “Great! How far away are you? OK, hurry. We’ll see you in ____ minutes. Bye.” Patient responds - “NO”, you say, “OK (name), you’re scheduled to see your Doctor today. You don’t want to lose any progress you’ve made. What can you do to make it in here today?” Keep repeating this question but acknowledging their considerations until they make it go right to be here. And possibly schedule for tomorrow. But if on a Corrective Care Program, they will need to schedule a Make-up Day (MUD). You can handle this at their next appointment. 2. If the patient is hurting or sick they especially need to be seen. “All the more reason you should come in.” **Excuses:** can’t afford it, scheduling problems, is out of pain, has more pain etc... - Address the concern - Commit them to just 1 more appointment so we can work out the problem, because we are concerned about going backwards and need to maintain what we have accomplished. - Notify someone to do a ROOM 4 when he/she arrives ### *Missed appointment Call: (Didn’t get a hold of them)* Missed appointment message left at the end of the shift that they didn’t show for: “Hello _____ this is ____ from Willow Creek Chiropractic. We had you scheduled at _____. Something must have come up so I am going to put you down for 5:30 tonight. We’ll look forward to seeing you then.” ### *Missed appointment call: (Got a hold of but feels better and won’t come in.)* “GREAT! The Doctor will be pleased you are doing so well. Let’s get you scheduled for a possible release exam. Is morning or afternoon better for you?” ### *Regular patient calling to schedule appointment:* “Hello it’s another great day at Willow Creek Chiropractic, this is ____, I can help you.” I need to make an appointment. “When was the last time you saw the doctor?” Last week “We can see you this afternoon or tomorrow morning, (next 2 slots of time) which works best?” This afternoon “We have 3 or 5 which works best?” ### *Calling a recent missed appointment (without suspected problems):* Hi _____ this is _____ from Willow Creek Chiropractic “We missed you on ____, is everything alright? Ok, let’s reschedule you is ____ or ____ better?” Notes: ['Full source page retained because branches and individual prompts are tightly coupled. Provisional 5:30 slot and identity assumption must not become unreviewed automation.', 'Ill/symptomatic patient requires clinical triage, not automatic encouragement to attend.'] ### grow-repeated-missed · Several consecutive missed appointments Sources: IMG_0364 ### Calling a patient that has missed several continuous appointments: Hi _____ this is _____ from Willow Creek Chiropractic “It's been awhile since we've seen you is everything alright?” Discover the problem and resolve it or get them in so someone else can resolve it. If they won’t reschedule tell the doctor. Record your communications. Notes: ['Escalate refusal to doctor and document communications as source directs.'] ### grow-inactive-call · Long-inactive patient — well, not helped, unwell branches Sources: IMG_0364 ### Calling a patient that hasn’t been in for a long time. Hi _____ this is _____ from Willow Creek Chiropractic “____ it has been quite some time since we have seen you, the doctor wanted me to call and see how you are doing. (review their symptoms) GOOD – (and you believe them) 1. Review previous symptoms 2. “Did we help you?” YES! 3. “Great, well we want to keep you feeling that way so lets schedule you for a maintenance check up, is morning or afternoon better?” 4. If they don’t schedule, “Is it ok if I follow up with you in the future to see how you are doing?” 5. “Who do you know that we could also help” (Get referral) If we did not help them or you discover a problem with our office then do your best to solve it and get them in and we will make it right. NOT GOOD “Tell me what’s going on?” (They may have felt better with treatment, quit coming in and now are hurting again. Or they felt that we weren’t helping.) Either way try to get them in to meet with the doctor so he can figure things out. Notes: ['Future-follow-up permission must be recorded; no cadence specified.'] ### grow-room4-question · Room 4 recommitment inquiry context Sources: IMG_0397 If you feel that the patient needs to be re-committed then at anytime have the x-rays pulled and up so that during your discussion you can do the 4 questions of commitment and find out for sure if they want correction, relief and to stop the degenerative process. Money, time etc. can all be resolved if they want to correct it. Many time we get caught up on money or they felt the adjustment didn’t go well or something that can distract them from the goal of fixing it. Notes: ['Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation.', 'This source paragraph references four questions elsewhere; link grow-reexam-questions. No invented quoted script.'] ### grow-visit7-referral · Seventh-visit testimonial/referral invitation Sources: IMG_0390 4. Still on the 7th visit meeting after the evaluation is done, this is the time to get their testimonial on cassette tape or VHS. By saying, “We would like to ask for your help. Our goal is to share chiropractic health with the community. Is there someone that you know that is in pain that we can help. (we also will lecture to business, or any place we can get a group together. We never charge and do this as a community service. Get the contact info and present it to the doctor. Praise them for keeping their appointments and telling their story so others can benefit. Notes: ['Referral and testimonial are optional; consent and approved claims apply.'] ### grow-day1-consult · Day 1 expanded consultation Sources: IMG_0392 ### Day 1 (Expanded) #### Consultation - Introduce yourself and take the patient back to the examination room. - Find out what they have heard that was positive (+) or negative (-) about chiropractic. - Your goal is to get them to open up about any health concerns they may have. If they don't have something they want to improve about their health then they will not likely they will become a patient. **“What have you heard about chiropractic? Positive or negative?”** (What else have you heard?) **“I see you have several health concerns and you listed ____ as your major concern. Tell me about it.”** (Find the top 2 concerns) **“How does it affect you at work, home, hobbies...?”** **“How old did you think that people should be when they had these problems?”........** [The goal is to get them to RUIN on the tone scale. A place mentally that they cannot continue living with their problems] [Write down your laundry list of what they said, especially any quotes they have said. This will be used on Day 2.] **“The doctor will be with you in a minute, but before he does, let me explain what he is going to look for.** *(point to the posters)* **Your brain controls your entire body through the nervous system.** *(Yellow nerves chart)* **These nerves cause pain and go to your head arms and legs.** *(Organ nerve chart)* **And these nerves go to all of your organs.** **Sometimes these bones can get knocked out of place** *(show this by poster, or model)*, **and when that happens the bone hits these nerves and puts pressure on them, chocking off the mental impulses that need to get to the tissue. Much like if you had a rubber band wrapped around your finger. What would happen if you had a rubber band wrapped around your finger? And then what would happen? And then what?** **If the bone is hitting a nerve of pain you will get pain.** *(point to the area on the yellow nerve chart that correlates with their pain, relate it to their pain)* **If it is hitting a nerve that controls the function of an organ** *(point and correlate the organ being affected on the Organ chart)*, **then the organ malfunctions and then the organ becomes diseased and dies, just like your finger would.** **If there is a bone out of place it will cause pain, swelling and spasms. The doctor will be looking for each of these 3 signs. When the bones can’t move properly arthritis or degeneration starts to grow the bones together. Like these.** *(show models)* **If the doctor finds that you have these misalignments or bones out-of-place causing your _____ and _____. Then you are in the right place and he is going to be able to help you. If not then he will find someone who can. Let's hope he finds something.”** ☐ Crack the door and get the doctor. Notes: ['Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation.', 'Source pressure/ruin and organ-death narrative retained for review, not approved automated delivery.'] ### grow-day1-doctor · Day 1 doctor findings-review explanation Sources: IMG_0393 The doctor will introduce himself, do the exam telling the patient what he has found. Then he will say **_“Tonight I am going to spend detailed time going over your exam and x-ray findings, tomorrow we will tell you what we have found. The x-rays will tell me if you have a muscle or ligament problem or if you have a subluxation. If you have a subluxation, it will tell me exactly where it is, how long you have had it and what we need to do to correct it.”_** He will also cover any costs and the importance of the spouse coming to the ROF. Notes: ['Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation.', 'Source x-ray certainty assertions are unverified; clinician must approve actual statements.'] ### grow-rof-invitation · ROF scheduling and companion agenda Sources: IMG_0393 - [ ] Set the ROF appointment for them and their significant other, either in the x-ray room, or when you bring them back to a consultation room. **“Our first available appointment is (date). Is there any reason you would not be able to attend it?”** - [ ] Go over the ROF appointment form with the patient by saying the following: “**_Now ____ the doctor wants to go over your findings with you and _____. _**(call them or reschedule if necessary to get them both there)**_ Now ____ this appointment will be the most important appointment you will ever have in our office. Here we will cover your results, care plan, finances, and home care instructions. You will also understand how miracles happen in our office. So you don’t miss any information, we ask that you find a baby sitter if you have children, and plan for about an hour. Do you have any questions?_**” Notes: ['Includes first available/date, companion, babysitter, hour-length and questions. Patient controls disclosure and companion participation.'] ### grow-day1-fees · Day 1 itemized payment or offer waiver Sources: IMG_0393 - [ ] **FEES** - **“Now it looks like the examination is 30, the x-rays are 120, so the total for today’s services are 150. How would you like to take care of that? We take cash check or credit card.”** If some of the services are at no charge then state all the *fees then after a short pause tell them what was not charged.* **“Now it looks like the examination is 30, the x-rays are 120, so the total for today’s services are 150. (pause) However because you came in from our drawing it is at no charge.”** Notes: ['Historical fees, discounts, free services and donation offers are source examples, not approved current terms. Review actual pricing, eligibility, payer rules and consent before use; no automatic charging or pressure for financial disclosure.', 'Original exam 30/films 120/total 150 is historical example, not live rate.'] ### grow-day2-commitment · Day 2 readiness, obstacles and staged fallback Sources: IMG_0394, IMG_0395 ## *Roll playing the commitment:* **What do you think will happen if you leave it alone?** **“Is this something you want to take care of?** **“Now, before you answer, you need to know that it is going to take a huge commitment on your part.** - You need to show up on time. - Should you miss an appointment you'll be required to make it up within 7 days. - You will be expected to perform some rehabilitation exercises at home. - We have a health care class that you will be required to attend, also we have classes on nutrition, exercise, stress and time management and other topics throughout the year. Attend as many as you can. **“In essence, you must become a very compliant patient in order to get the results that you need and want.** **So on a scale of 1-10, where are you?** An 8 **Why not a 10?** Objection Handle **So what are you now?** A 9 **Why not a 10?** Objection Handle **So what are you now?** A 10 Great. *[Continue until the patient states he is at a 10. You are not finished until the patient says 10 quickly and looks happy about it. “Now that’s not a happy 10. What’s with that?” If you cannot get them to a 10 you may have to shift to the “by stages” approach and simply ask him whether he would prefer to first monitor his own progress before committing to the full program. Then seek a commitment to the first re-exam. (can tie it back to the timeline of care.)]* **Question #2: (The obstacle question)** **“What is it that might prevent you from starting and staying on your corrective care program, all the way through to completion?” (Even if the patient had an enthusiastic answer to the first question, still ask question #2. He probably has concerns.)** Objection **Handle** **“What else would prevent you?”** **Objection** **Handle** **“What else would prevent you?”** # Question #3: **“So, all ready to get started?”** *[Now they should be ready to have you explain the financial obligations. Refer to chapter #6 in this manual.]* Notes: ['Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation.', 'Preserves full historical 1–10 loop and staged-first-reexam fallback; current approved version must respect voluntary decision.'] ### grow-reexam-questions · Four re-exam questions and stated adherence ask Sources: IMG_0401 - 4 questions are gone over 1. **What do you remember about your x-rays?** 2. **What is it doing to your spinal cord, nerves and organs?** 3. **What will happen if it is not corrected?** 4. **You are scheduled ___ times in the next month. On a scale of 1-10. How committed are you to keeping all of these appointments.** (If less than a 10 then handle it and get them to a 10) Notes: ['Preserve the source script as historical text; clinical explanations, promises of cure, broad organ/disease claims and pressure-oriented language require clinician/editor review before patient-facing approval. Staff must not diagnose or assert findings without doctor confirmation.', 'Actual clinical findings replace generic assumptions only in separately approved copy.'] ### grow-rereport-improved · Improved comparative-film discussion Sources: IMG_0399 **The new films are improved compared to the first. What do you say?** - This is your first film. What was wrong with it? - This is your follow-up film. What do you see? - That is right it is improved about ____ %. You have done what we have asked and you are on track. Now we are changing your visit schedule to ____. Notes: ['Only clinician-confirmed comparison/percent/schedule may populate source placeholders.'] ### grow-next-visit · Next-visit reminder Sources: IMG_0402 11. Pay attention to the patient’s calendar and their next visit. Make sure the schedule is marked correctly and remind them of their next appointment. **“Check you Wednesday!”** Notes: ['Source example “Check you Wednesday!” preserved.'] ## Source decisions and limitations ### Two incompatible missed-visit thresholds IMG_0248 moves a 3x/week patient to weekly recall after one week; IMG_0241 says two weeks and adds day-three email/doctor attempt. Proposed software must display both and obtain a clinic policy decision before activation. Do not quietly blend them. Sources: IMG_0241, IMG_0248 ### Detailed financial branches clarify a compact outline IMG_0267 lists one-time/monthly/three visits/modified. IMG_0283 explicitly routes disclosed finances to a modified plan and nondisclosure to a three-visit trial. Cross-part IMG_0359–0360 reinforces the detailed branches and states regular per-visit trial pricing. Proposed canonical flow follows the detailed conditional source; keep the shorter outline traceable without inventing a contradictory mandatory sequence. Sources: IMG_0267, IMG_0283 ### The digitizable core is ownership plus evidence The strongest source controls are three-in/two-out, CAL/COM/LA/RE/RR flags, scheduled/not-scheduled bins, signed cross-role routing, Pending clearance, daily calendar carry-forward and twice-per-shift mailbox emptying. A task engine should preserve these dependencies and provide overdue visibility, not simply send messages. Sources: IMG_0244, IMG_0250, IMG_0261, IMG_0282 ### Prescribed calls remain calls Twenty-minute no-show phone call, stage reminders and doctor call list are human telephone actions. Additional SMS/links are proposed companion touchpoints; source explicitly permits call or text for monthly/forgetful-patient day-before reminders. Sources: IMG_0241, IMG_0242, IMG_0247, IMG_0248, IMG_0262 ### Historical clinical claims are review-only Subluxation/organ death, guaranteed correction/miracles, x-ray duration claims, pressure for a happy10 and rejection of medicine appear in source. Preserve exact text for fidelity, clearly label it, and prevent automatic delivery until qualified review. The proposal must not present these as verified facts. Sources: IMG_0271, IMG_0272, IMG_0273, IMG_0275, IMG_0278, IMG_0289, IMG_0290, IMG_0291 ### Historical legal/financial forms need current policy Old Utah insurance minimums/claim periods/WC rules, finance interest, collection fees, discount clawback and Care Credit refund language are unverified. The X on the Care Credit clause does not unambiguously authorize or remove it. Sources: IMG_0278, IMG_0279, IMG_0284, IMG_0288 ### No hard-coded clinical imaging cadence Source says re-exam every12 visits and new imaging on second or third. The actual exam/imaging indication and qualified operator must remain clinician-controlled; no automatic x-ray order based only on visit count. Sources: IMG_0266, IMG_0276 ### Marketing Primary Script is an external section dependency IMG_0247 and training IMG_0266 reference Primary Script; this segment does not contain its full marketing version. App merge must attach the script in another segment to marketing and missed-Day1 recovery. Sources: IMG_0247, IMG_0266 ### Template variants and blank SOPs remain visible IMG_0239 and IMG_0260 are duplicate front-desk sheets. IMG_0235 and IMG_0246 are annotated variants (Initial Consult). IMG_0252 six payment steps are blank; IMG_0282 3 STACK TRAYS is a bare heading. Do not invent omitted text. Sources: IMG_0235, IMG_0239, IMG_0246, IMG_0252, IMG_0260, IMG_0282 ### Source stage and notation dictionaries need normalization RE2, REEC and RREC all refer to imaging/re-exam contexts but are not explicitly standardized; ROF may be group/private/mini. Manual/computer books and TC calendars must share states while preserving source labels. Sources: IMG_0242, IMG_0251, IMG_0261, IMG_0276, IMG_0285 ### Permission-based referral is explicitly in the book Re-exam referral script asks the patient to obtain referred person permission before doctor calls. Gift thank-you is triggered by an actually arrived referral. Preserve this distinction rather than putting every mentioned person into automatic outreach. Sources: IMG_0257, IMG_0276 ### Public proposal must not publish personal operational data The example ledger carries real handwritten financial totals; phone/contact templates include historical numbers. Use structural fields and source references in public proposal; no patients, private clinician contacts or runtime secrets. Sources: IMG_0238, IMG_0254, IMG_0262 ### Capture completion rather than assuming it A proposed appointment message is not confirmed attendance; a file being placed in a tray is not recipient acknowledgment; a call list delivered to doctor is not call completed. Proposed receipts/acknowledgments deliberately strengthen these source handoffs. Sources: IMG_0241, IMG_0248, IMG_0261, IMG_0262 ### Page review method All 55 assigned transcriptions and record metadata reviewed; independent OCR cadence anchors compared; original images IMG_0246 and IMG_0248 inspected for workflow-critical amendments. Dense table pages already have Luna verification; numerical handwritten ledger is not a source for modern rates or targets. Sources: IMG_0246, IMG_0248 ### Doctor call-list timing is expanded elsewhere Cross-part IMG_0295 requires first-adjustment calls before leaving, doctor list calls that night, return notes next day and keep a copy of unresolved items. Canonical workflow must merge these deadlines with this segment’s list fields/handoff. Sources: IMG_0262 ### Relief-care choice must remain explicit IMG_0249 offers monthly relief follow-up as one option. Cross-part IMG_0297 describes a patient choosing symptom-only relief with no further appointments and a consented check-in after an unspecified number of months. These are different patient choices, not an automatic monthly care rule. Sources: IMG_0249 ### Final recovery disposition expanded elsewhere Cross-part IMG_0368 routes unresolved recovery notes to Quality for decision and moved/deceased cases into EXIT FORM. Merge into recall/discontinuation terminal branches; do not leave moved/deceased people on routine outreach. Sources: IMG_0241, IMG_0248, IMG_0249 ### Primary Script found across sections Cross-part IMG_0339 contains compact Primary Script and scheduling; IMG_0349/0366 contain expanded scripts. Canonical marketing and missed-Day1 tasks need these source-script links after app merge. Sources: IMG_0247, IMG_0266 ### Part 2 page coverage All 55 assigned photographs IMG0292–0346 were read in transcription and record metadata. OCR passages were compared across every page; images0307,0309,0314,0315,0316,0323,0326 were additionally inspected for consequential source wording. No assigned photograph is omitted. Sources: IMG_0292, IMG_0293, IMG_0294, IMG_0295, IMG_0296, IMG_0297, IMG_0298, IMG_0299, IMG_0300, IMG_0301, IMG_0302, IMG_0303, IMG_0304, IMG_0305, IMG_0306, IMG_0307, IMG_0308, IMG_0309, IMG_0310, IMG_0311, IMG_0312, IMG_0313, IMG_0314, IMG_0315, IMG_0316, IMG_0317, IMG_0318, IMG_0319, IMG_0320, IMG_0321, IMG_0322, IMG_0323, IMG_0324, IMG_0325, IMG_0326, IMG_0327, IMG_0328, IMG_0329, IMG_0330, IMG_0331, IMG_0332, IMG_0333, IMG_0334, IMG_0335, IMG_0336, IMG_0337, IMG_0338, IMG_0339, IMG_0340, IMG_0341, IMG_0342, IMG_0343, IMG_0344, IMG_0345, IMG_0346 ### Shared Day1/Day2/ROF and reception responsibilities Many doctor-side actions duplicate or continue reception/enrollment chapters outside this part. Merge by patient event and owner handoff rather than running parallel outreach sequences. Shared events include first-adjustment completion, missed ROF, re-exam due, ROF enrollment decision, Doctor Call List and calendar change. Sources: IMG_0295, IMG_0299, IMG_0301, IMG_0302, IMG_0303, IMG_0304, IMG_0305, IMG_0307, IMG_0308, IMG_0309, IMG_0335 ### No clinical auto-pilot The book contains valuable administrative triggers alongside clinical claims, manipulative scripts and potentially unsafe reassurances. Preserve exact archival text and linked images, but distinguish approved human tasks from review-only clinical content. Proposed orchestration cannot diagnose, prescribe imaging, change treatment, dismiss symptoms or automatically send those passages. Sources: IMG_0294, IMG_0295, IMG_0301, IMG_0305, IMG_0306, IMG_0311, IMG_0317, IMG_0318, IMG_0321, IMG_0326, IMG_0327, IMG_0328, IMG_0332, IMG_0334, IMG_0344 ### Records marking erasure is printed, not OCR error IMG0307 explicitly says to erase markings when departing patient is negative; original image was rechecked. Keep this in coverage/audit as a rejected-for-activation source policy. Modern departure proposal must preserve records and use an approved release/amendment process. Sources: IMG_0307 ### Comparison imaging threshold conflict IMG0309 says before card end or35th visit while also saying24–36 at doctor discretion. Other pages say24th/36th or2–3 months; IMG0311 says first followup at least2 months. Record the discrepancy and require a clinician-approved review milestone. Source recurring imaging must never become automatic exposure orders. Sources: IMG_0309, IMG_0310, IMG_0311, IMG_0312, IMG_0322 ### Analog processor refill conflict IMG0315 says refill at one gallon; IMG0316 recipe starts at two gallons and adds five to reach seven. Both original images confirm the differing numbers. Treat analog processing as conditional legacy equipment reference; use manufacturer-approved instructions if relevant. Sources: IMG_0315, IMG_0316 ### Blank relief-only recontact cadence Relief-only patient explicitly has no further appointments; receptionist records a check-in in blank months. The month interval is not supplied. It must be individualized and consented; do not silently replace with recurring monthly care. Sources: IMG_0297, IMG_0308 ### Exact clinical objection answers absent IMG0326 lists rib pain, fear, children/babies, physician disagreement, stroke, worsening pain and billing objection prompts without authored replies. Archive them as unresolved training prompts. Modern response scripts need clinical/policy review, not invented quotations from the author. Sources: IMG_0326 ### Referral consent and family autonomy are modernization additions Doctor call within next day or two and family checks within first two weeks are explicit. Contact authorization, third-party privacy checks, opt-out states and voluntary family participation are necessary proposed controls, not claimed to be book instructions. Sources: IMG_0295, IMG_0303, IMG_0304, IMG_0333, IMG_0345 ### Named current owners replace historical people and rooms Dr. Thomas, Joshua, room4, Division5/7, film slots, manual appointment book and3x5 cards indicate role/queue boundaries. Map them to current named accountable owners and secure records; do not copy historical personal identities or clinic addresses into actual contact sequences. Sources: IMG_0292, IMG_0294, IMG_0297, IMG_0312, IMG_0322, IMG_0328, IMG_0342 ### Historical fees and inconsistent family offer IMG0303 gives $30 exam/film examples and family free films within two weeks vs exam-only after. IMG0325 offers family free checks including films generally. Preserve both and require one current approved offer and clinically justified imaging, not automatic free-film scheduling. Sources: IMG_0303, IMG_0304, IMG_0325, IMG_0345 ### Marketing cadence ambiguities IMG0341 gives different home-calling windows in alternate examples; IMG0342 bi-weekly calls ambiguous; IMG0345 bi-monthly appreciation ambiguous while IMG0340 explicitly every two months. Source targets are author benchmarks, not forecasts. No numeric unredeemed-PGC interval is specified. Sources: IMG_0338, IMG_0340, IMG_0341, IMG_0342, IMG_0343, IMG_0344, IMG_0345 ### Patient choice terminates automation The user asks for no missed personnel duties, not involuntary patient retention. Proposed states must distinguish unresolved office task from a patient declining, opting out, completing relief care, transferring or receiving alternate clinical care. Source control language cannot justify endless chasing. Sources: IMG_0297, IMG_0307, IMG_0308, IMG_0321, IMG_0328, IMG_0332 ### Suggested digital control layer Each source task becomes an owned event with due time, role-specific script link, exact source, action evidence, handoff acknowledgement and stop condition. SMS supplements explicitly prescribed calls, especially confirmation/directions, without replacing them. Retry counts and escalations absent from the book remain labeled proposed decisions. Sources: IMG_0294, IMG_0295, IMG_0299, IMG_0302, IMG_0319, IMG_0322, IMG_0326, IMG_0337, IMG_0338, IMG_0339 ### Clinical reference remains covered without becoming workflow rules Anatomy definitions, film-positioning diagrams, manual techniques and rehab parameters are fully represented in page obligations and linked source files. Their disposition in the proposed system is clinician-only reference or current-protocol review, not a dropped page and not an executable treatment algorithm. Sources: IMG_0313, IMG_0314, IMG_0315, IMG_0316, IMG_0317, IMG_0318, IMG_0323 ### Marketing statistics continue into next photo group IMG0346 instructs recording on the following stat sheet. Marketing forms and detailed prospect followup continue beyond IMG0346; link to the next research part instead of inventing fields/cadence. Sources: IMG_0346 ### An attempt does not resolve a patient obligation Proposed completion semantics distinguish the book’s duty to make/record calls from a resolved patient need. An unanswered attempt can complete an attempt subtask, but an unanswered first-adjustment check remains doctor-owned and other unresolved outreach remains assigned. Daily checklist/call-list handoff can close without silently closing those patient objectives. No unanswered-call retry cadence is supplied or invented here. Sources: IMG_0295, IMG_0299, IMG_0304, IMG_0337, IMG_0338 ### Source-complete assigned scope Read all 56 assigned transcriptions, all record metadata and OCR files. Directly inspected IMG 0400/0401 originals where background text and threshold contradictions matter. All 56 photos retain page-specific obligations and traceable script/workflow links; reference pages 347/348 are preserved, not converted into invented actions. Sources: IMG_0347, IMG_0348, IMG_0349, IMG_0350, IMG_0351, IMG_0352, IMG_0353, IMG_0354, IMG_0355, IMG_0356, IMG_0357, IMG_0358, IMG_0359, IMG_0360, IMG_0361, IMG_0362, IMG_0363, IMG_0364, IMG_0365, IMG_0366, IMG_0367, IMG_0368, IMG_0369, IMG_0370, IMG_0371, IMG_0372, IMG_0373, IMG_0374, IMG_0375, IMG_0376, IMG_0377, IMG_0378, IMG_0379, IMG_0380, IMG_0381, IMG_0382, IMG_0383, IMG_0384, IMG_0385, IMG_0386, IMG_0387, IMG_0388, IMG_0389, IMG_0390, IMG_0391, IMG_0392, IMG_0393, IMG_0394, IMG_0395, IMG_0396, IMG_0397, IMG_0398, IMG_0399, IMG_0400, IMG_0401, IMG_0402 ### Recaptured operational pages are aliases Later book photos repeat earlier training pages:391→312,392→271,393→272,394→273,395→274,396→275,397→277,398→371,399→310,400→311,401→309,402→300;365→364. Proposed runtime must merge these source supports onto canonical workflows. grow- IDs are extraction identifiers, not permission to run duplicate sequences. Sources: IMG_0365, IMG_0391, IMG_0392, IMG_0393, IMG_0394, IMG_0395, IMG_0396, IMG_0397, IMG_0398, IMG_0399, IMG_0400, IMG_0401, IMG_0402 ### Primary Script has material variants IMG 0349 says “get rid of it permanently” and has fuller symptom/referral exploration; IMG 0366 says “help you” and adds three price-inquiry responses. Both are retained as versioned historical source; one approved patient-facing working version must be chosen explicitly. Sources: IMG_0349, IMG_0366 ### Marketing calendar cadence is layered Source calls for 4 outside meetings/week,2 outside lectures/week,weekly outside event,monthly screening/monthly fair,monthly advanced talk,8–12 annual advanced talks/PADs and alternating-month three-week promos. These may overlap; owner must define counts and events rather than accidentally create parallel duplicate obligations. Sources: IMG_0353, IMG_0373, IMG_0374, IMG_0377 ### Education handout cadences differ by asset M/W/F new handout on seats and changed whiteboard is explicit; Monday/Thursday new testimonial distribution is separately explicit. Track two asset types rather than silently choosing one cadence. Sources: IMG_0372, IMG_0373 ### Incomplete referenced materials Agenda 2 pages 13–19 invitation/update/flyer/gift/history/poster forms, past teleconference recordings, EXIT FORM content and nonprofit speakers bureau evidence are referenced but not reproduced in this section. Before implementation, locate supplied counterparts elsewhere or mark unavailable; do not fabricate an “exact original” template. Sources: IMG_0368, IMG_0373, IMG_0375, IMG_0380, IMG_0382, IMG_0385, IMG_0388 ### Reactivation campaign contains copied labels Valentine mailing step names Start the Year Healthy and Valentine call says start the year. Preserve source faithfully; approved adaptation can correct seasonal context but must be labeled editorial rather than verbatim. Sources: IMG_0382, IMG_0383 ### Source calls remain calls Five-day calls after reactivation, charity and family mailings; night-before Day 1 calls;20 minute missed-visit calls; physician nonresponse calls and promised PGC couple-day call must remain human-call obligations. SMS links/confirmations are inferred companion touchpoints with consent, not replacements or book quotations. Sources: IMG_0350, IMG_0351, IMG_0363, IMG_0378, IMG_0380, IMG_0383, IMG_0385, IMG_0388 ### Cadences missing outside named timers The book does not specify retries, maximum attempts, business/calendar-day treatment, quiet hours, opt-out handling or bounce/wrong-number rules for most sequences. Proposed named-owner queues, verified contact eligibility, wait states, cancellation on reply/booking and manager exception review fill these gaps and must be visibly marked inferred. Sources: IMG_0350, IMG_0351, IMG_0364, IMG_0377, IMG_0378, IMG_0380, IMG_0385, IMG_0388 ### Exact follow-up timing anchors need definition Campaign calls are 5 days later, usually after mailing. For Family Day hand delivery, anchor is ambiguous; proposed recorded delivery date is an inference. PGC “couple days” and physician “several days” should remain text until approved configuration. Sources: IMG_0351, IMG_0378, IMG_0380, IMG_0383, IMG_0385, IMG_0388 ### Imaging threshold conflict confirmed visually IMG 0401 states review before end of card or 35 thvisit and also generally 24th–36 that doctor discretion. No threshold has been silently selected. IMG 0400 foreground is worse-film continuation; faint underlying re-exam text is independently legible in 0401 and not a separate missed page. Sources: IMG_0400, IMG_0401 ### Patient autonomy and clinical truth need approved working copy Book includes “ruin” framing, insisting on a happy 10, inferred financial distrust, x-ray-concern urgency without case evidence, broad organ-disease claims and normalization of worsening. Preserve exact originals as reviewable source, but runtime scripts require respectful, truthful clinician-approved wording. Automated scheduling cannot order imaging, diagnose, change rehab or excuse deterioration. Sources: IMG_0349, IMG_0360, IMG_0361, IMG_0366, IMG_0392, IMG_0394, IMG_0399, IMG_0400, IMG_0402 ### Financial and promotional terms are historical examples 20% one-time and 15% reactivation prepay;55 visit/30 film;150 Day 1;35 coupons;12/17 dollar donations;freeDay 1–3 or massage variants;5–20 charity range and prize budgets are different contextual source examples. Retain in proposal evidence, require current approved price/offer versions before workflows activate. Sources: IMG_0359, IMG_0360, IMG_0374, IMG_0375, IMG_0380, IMG_0383, IMG_0385, IMG_0387, IMG_0389, IMG_0393 ### Testimonial permission is source-grounded Book explicitly requires patient reads typed story and signs authorization before display. Proposed evidence links and permitted-channel tracking extend this existing requirement. Do not treat testimonial capture alone as permission to publish. Sources: IMG_0371, IMG_0372, IMG_0379 ### Physician rewards conflict resolved by specific campaign General networking page discusses rewards only after speaking to doctor. Specific physician mailing sequence explicitly says no gifts and monthly maximum. Use the specific no-gift rule for physician campaign; any other reward still needs policy review. Sources: IMG_0355, IMG_0378 ### Prevent simultaneous duplicate recovery Reception, Marketing and Enrollment are all told to work missed-Day 1 pool. Proposed single record/primary owner/shared activity and contact lock lets teams assist without three overlapping call/text sequences. Sources: IMG_0369 ### Source-led patient pipeline Derived states: lead→qualified/evaluation invited→Day 1 scheduled/confirmed→Day 1 attended→ROF prepared/scheduled→ROF attended and care decision→financial option→Day 3 complete→active care→visit 7 check→12 visitre-exams→clinician-selected comparative report→renewal/maintenance. Parallel exceptions cover missed stages, MUD, Room 4, inactive return, reactivation and QC/exit. Marketing has separate partner/event/campaign/lead pipelines feeding this patient journey. Sources: IMG_0349, IMG_0361, IMG_0363, IMG_0368, IMG_0369, IMG_0390, IMG_0392, IMG_0393, IMG_0394, IMG_0395, IMG_0396, IMG_0399, IMG_0401 ## Complete page register ### IMG_0235 · Inbound calls: classification, source capture and appointment close Telephone intake for new/existing patients and common question branches. - Ask last doctor visit to distinguish new versus existing. - New: name/phone, referral source, self/family, appointment and directions. - Existing: appointment using morning/afternoon choice. - Answer insurance/children/hours/price questions and invite scheduling. - Preserve historical all-insurance/free-consult/fee-deflection text as review-only until actual policy confirmed. Workflows: rec-inbound-booking, rec-family-invitation Scripts: rec-inbound-questions Uncertainty: ['The adjacent sheet is cut off at the left edge; only suffixes of several lower schedule labels are visible.', 'The number of periods after “better” in the existing-patient parenthetical is difficult to distinguish; seven are transcribed.'] Disposition: mapped ### IMG_0238 · Example reception collections and patient-visit ledger Completed December example showing daily, weekly and monthly reception performance fields. - Maintain month/year and two receptionist columns. - Track cash/check, credit-card, total OTC and PV by weekday. - Calculate weekly and monthly totals and retain adjustments. - Do not promote crossed-out handwritten arithmetic to verified accounting. Workflows: rec-collections-ledger Scripts: Uncertainty: ['The struck-through figure in the third WEEK TOTAL amount cell is obscured and is transcribed as [illegible].', 'Faint show-through is visible near the right edge, but no words or numbers there are confidently readable.', 'Very low OCR similarity (0.1528); tabular handwritten totals are archival examples, not operational business rules.'] Disposition: mapped ### IMG_0239 · Front Desk Manager daily and weekly checklist Role-owned opening, lunch, closing and weekly planning controls. - Start team huddle on time with required people; retrieve/distribute messages. - Before lunch: pull travel cards, call misses, clear Pending, transfer phones, review misses with doctor. - End of day: doctor call list on counter, NP log current, cards pulled/books printed, misses called and missed Day 1 in NP Missed Log. - Verify live M–F 8–5 phone coverage, clear Pending, review doctor misses and reconcile Cash Practice/payment log/payments/receipts. - Record reactivations, prior/current-week PV and petty cash by day. - End week: next quota graph/battle plan and Saturday printout. - Friday gap = next-week PV target minus booked visits plus 10% target; submit completed sheet to Division 7 and state help needed. Workflows: rec-phone-coverage, rec-recall-lists, rec-missed-onboarding, rec-doctor-calls, rec-cash-drawer, rec-frontdesk-shift, rec-weekly-targets, rec-collections-ledger Scripts: Uncertainty: ['Faint reversed text shows through the paper; no words can be confidently distinguished, so it is marked [illegible].', 'The two printed symbols before the end-of-week action items are checkmark-like; they are transcribed as ✓.'] Disposition: mapped ### IMG_0240 · Receptionist: calendars, commitment and concern detection Enforce understood clinician recommendations, maintain every patient’s status and detect dropout at each visit. - Introduce role and ask patients to call if an emergency changes plans. - Execute three things in/two out and observe arrival/departure mood. - Give understood calendar copy, enter computer and reconcile changes by day end. - Use CAL when recommendation unknown; COM when known but not being kept. - After unannounced missed visit, discuss on return and reconfirm calendar/contact expectation. - Repeated misses: Enrollment Room 4, doctor non-adjusting-hours consult or suitable private front-desk discussion. - Book ROF/Day 3/calendar deliberately; if dropout suspected secure one further private problem-solving appointment. Workflows: rec-calendar, rec-arrival, rec-checkout, rec-special-consult, rec-room4, rec-frontdesk-shift Scripts: Uncertainty: ['At the far left, an adjacent sheet is partly visible. Its handwritten fragment appears to end in “r De”; the preceding text and the partial table/handwriting are cropped or illegible.'] Disposition: mapped ### IMG_0241 · Receptionist: missed visits, patient awareness and daily outreach Intensive recovery variant plus active/inactive ownership and friction-free checkout. - Review both books at every huddle. - Collect home/work/cell on Day 1. - Call within 20 minutes; at least twice to all available numbers daily; initially leave one message. - Source escalates to emergency contact/personal or blocked line if no show/call: preserve as review-only. - At three days no contact send email and ask doctor to call. - At two weeks daily calling remove future appointments and create Saturday recall with notes. - If doctor/reception fail, ask Executive Director. - Know all active/inactive statuses; investigate refusal, schedule consult/exit exam if appropriate and inform doctor. - Protect ROF/Day 3 attendance; source calls 20–80 people in non-adjusting hours. - Use make-ups around vacation; verbally acknowledge adherence and gift arrived referrals. - Use agreed prepay/card/check arrangements and prepared receipts to avoid bottlenecks. Workflows: rec-missed-visit, rec-recall-lists, rec-reactivation, rec-referral-reward, rec-otc-payments, rec-frontdesk-shift Scripts: rec-missed-visit-message Uncertainty: [] Disposition: mapped ### IMG_0242 · Receptionist: inactive return, reminders, coverage and special meetings Route returning inactive patients to private review, capture intake promises and prepare the appropriate meeting. - Do not send long-absent walk-in directly for adjustment; seat and route doctor/Enrollment Room 4. - Record referral source, promised initial fees and insurer atop intake; read returned clinician instructions, explain/collect fees, book ROF. - Day-before call or text for monthly visits and patients needing memory support. - Keep live phones M–F 8–5. - Trained Enrollment may do RR/RREC; without trained staff doctor does it outside adjusting hours. - Keep both books accurate and maintain visible quota/battle plan. Workflows: rec-phone-coverage, rec-special-consult, rec-inactive-return, rec-reminders, rec-day1-frontdesk, rec-rereport, rec-weekly-targets Scripts: Uncertainty: ['Fragments of text from an adjacent page are visible at the far right edge (including “Wi” and “Ad”); a small upside-down “ng” fragment is also visible near the lower right. These are cropped and not part of page 51.'] Disposition: mapped ### IMG_0243 · Patient appointment calendar template Patient copy of monthly calendar and historical adjusting/non-adjusting hours. - Supply patient name/time and monthly appointments. - Patient calls receptionist for time changes. - Source hours M/W/F 8–11am and 3–6pm, Tuesday 3–6pm; special appointments outside adjusting hours via reception. Workflows: rec-calendar Scripts: Uncertainty: ['The binder clip obscures the beginning of “Non-Adjusting” and the beginning of “adjusting” on the next line; the visible portions read “on-Adjusting” and “justing.”', 'The page number at the bottom right is faint but appears to read 11.'] Disposition: mapped ### IMG_0244 · Three things in, two things out and clinician flags Exact reception checks and CAL/COM/LA/RE/RR routing; returning inactive branch. - Know all active/inactive status; record outcomes on travel card and computer. - Resolve barrier or route Enrollment/doctor. - Three in: visible committed calendar, visible understandable financial, known special-appointment need. - Use LA last scheduled visit; CAL unknown calendar; COM nonadherence; RE re-exam room; RR Enrollment ready. - Before sending back date card, check three items, highlight arrival. - Two out: inspect changed calendar and remind next appointment. - Travel-card and computer calendar must match. - Returning inactive: seat after sign-in then Enrollment Room 4 to review absence/goals, new exam/imaging/accident/work injury and prior findings. Workflows: rec-calendar, rec-arrival, rec-checkout, rec-inactive-return, rec-room4, rec-auto-intake, rec-workers-comp Scripts: rec-calendar-clarify Uncertainty: ['The source visibly has an opening parenthesis after “3 things in” with no closing parenthesis before the paragraph ends.'] Disposition: mapped ### IMG_0245 · Phone coverage, two-choice scheduling and Pending workflow Phone ownership, message routing and time management with batch entry. - Own live M–F 8–5 coverage and correct answering message; delegate coverage explicitly. - Record and route messages; submit source off-clock $1/message/$10 arrived NP incentive events for payroll review. - Use greeting, caller/subject questions, morning/afternoon and two-date/two-time choice. - Make outbound calls during quiet adjusting periods and non-adjusting hours. - Use strong clear agreements; resolve concerns or book private resolution. - Use automatic agreed payments to reduce front-desk computer time. - Place calendar/payment entries in Pending; complete after adjusting or slow periods; teammate can help at day end. Workflows: rec-phone-coverage, rec-inbound-booking, rec-otc-payments, rec-frontdesk-shift, rec-task-handoff Scripts: rec-phone-greeting Uncertainty: ['A faint arrow-like handwritten mark appears in the margin near “Taking a message”; it has no readable wording.', '“Willow Creek” in the greeting is visibly struck through.'] Disposition: mapped ### IMG_0246 · Inbound calls with handwritten Initial Consult amendment Near-duplicate of page 15 with a meaningful handwritten change to the fee response. - All IMG_0235 new/existing/question branches remain. - First “no charge to meet with doctor” phrase is struck through and “Initial Consult” added; preserve version difference. - Do not assume the unchanged later free-consult phrases resolve the amendment. Workflows: rec-inbound-booking, rec-family-invitation Scripts: rec-inbound-questions Uncertainty: ['The number of periods after “better” in the existing-patient parenthetical is difficult to distinguish; transcribed as six periods.', 'The first “There is no charge to meet with the doctor” is crossed out, and “Initial Consult” is handwritten above it. The extent of the strike-through is represented as covering that phrase.', 'Direct image inspection confirmed annotation; this is a variant, not an exact duplicate.'] Disposition: mapped ### IMG_0247 · Outbound, reminder calls and missed onboarding stages Phone goals and distinct Day 1/Day 2 reminder and Day 1/2/3 failure hypotheses. - Recently missed: call/reschedule or message proposed make-up. - Repeated multiple-appointment misses: discover what changed and route in for assessment. - Marketing leads from survey/cards/referrals use source-specific introduction then Primary Script. - Goal five inactive patients rebooked daily. - Day 1 reminder asks directions; forgotten appointment is rescheduled and concern clarified. - Day 2 reminder asks written questions and resolves attendance/support-person logistics. - Missed Day 1 revisit Primary Script; missed Day 2 review initial visit; missed Day 3 examine decision-maker/financial comfort. Workflows: rec-missed-visit, rec-reactivation, rec-reminders, rec-missed-onboarding, rec-marketing-call Scripts: rec-day1-reminder, rec-day2-reminder Uncertainty: ['The handwritten replacement on Day 2 appears in lowercase as “schraedel”; the handwriting is legible, but its capitalization is less distinct than the Day 1 replacement.'] Disposition: mapped ### IMG_0248 · Missed visits: rapid call, weekly recall and monthly recall Detailed alternative missed-visit procedure and doctor participation. - Call within 20 minutes and leave first message. - If absent all day call that night and reschedule make-up for next day (handwritten revision). - Continue calling without more messages if still no reply. - After one week for 3x/week calendar remove future appointments, use Saturday AM recall with LA, print Monday and call all week. - Remove from Saturday list after contact plus scheduling; copy card to doctor. - Explicit decision can shift to first-Saturday PM monthly recall; first Saturday contains both groups. - Source doctor calls varied times/numbers/work/spouse; preserve without automating privacy-invasive outreach. Workflows: rec-missed-visit, rec-recall-lists Scripts: rec-missed-visit-20min Uncertainty: ['The handwritten replacement in item 2 appears to read “re Schedule them”; its spacing and capitalization are somewhat uncertain.', 'Image checked: “re Schedule them” overwrites “put them down.” One-week rule is legible and conflicts with IMG_0241 two-week variant.'] Disposition: mapped ### IMG_0249 · Four reasons patients stop and matching recovery branches Separate feeling-well, no-benefit, money and unexplained-discontinuation pathways. - Feeling well: propose clinician consult; clarify correction/relief preference; source suggests monthly relief, then ask comfort returning if declined. - Not improving: doctor reevaluation, care change or referral. - Money: Enrollment meeting to find arrangement. - Unexplained stop: ask honest improvement/offense feedback and record what happened. - Respect a declined appointment and route clinical statements to qualified review. Workflows: rec-reactivation, rec-discontinuation Scripts: rec-recontact-branches Uncertainty: ['The opening quotation mark before “When your pain returns” is visible, but no closing quotation mark is apparent after “the office?”.', "The second category heading visibly reads “The don't feel the treatment is working.” Its wording is anomalous, but it is legible as printed."] Disposition: mapped ### IMG_0250 · Shift-end missed-visit review and post-it key Doctor/reception jointly review no-shows and walk-ins; flags avoid leaving front desk. - At each shift end compare both books with doctor; nonhighlighted people missed, handwritten additions walked in. - COM recommit known plan; CAL clarify unknown plan; LA obtain new plan. - RE means room/films ready for re-exam; RR means first/second films ready for comparison. - Remove RE/RR when Enrollment already completed to avoid duplicate work. - RNB is source cue to doctor to focus and speed up. Workflows: rec-calendar, rec-checkout, rec-rereport, rec-frontdesk-shift Scripts: Uncertainty: [] Disposition: mapped ### IMG_0251 · Appointment abbreviations and visit-type scheduling Shared notation and special-consult timing. - Maintain NP, ROF yellow, RE each 12 visits, RE2/REEC imaging, RR, Room 4, massage M, laser L, SC. - Highlight arrived name; RS date/time, NS/NC, cancellation CA, MUD, LA and EOC remain distinct. - D3 requires Enrollment; FIN includes staff initials and green highlight at start of day. - Record reschedules in correct book and computer. - Use historical adjusting hours, preferably slower slots for families/older patients. - Special consults are 15-minute blocks outside adjusting; reception may book, but doctor early/late attendance needs clearance. Workflows: rec-calendar, rec-arrival, rec-checkout, rec-special-consult, rec-missed-visit, rec-reexam, rec-plan-end-review Scripts: Uncertainty: ['The text appears to have two periods after “time”; both are retained.'] Disposition: mapped ### IMG_0252 · OTC payment markings and petty cash Receipts, prepaid balances, cash float and incomplete payment procedure. - Paid red ink; owed-unpaid pencil; prepay red line through paid visit. - Clarify uncertain arrangements with Enrollment. - Every payment gets receipt; paper copies white patient/yellow Barb/pink retained. - Source drawer $203 used to break bills; source also suggests agreed extra visit prepayment. - Count and lock drawer nightly, retrieve with key each morning. - “Taking a payment” steps 1–6 are blank; no detailed sequence supplied. Workflows: rec-otc-payments, rec-cash-drawer Scripts: Uncertainty: [] Disposition: mapped ### IMG_0253 · Day 1 reception/enrollment/treatment checklist Cross-role initial-visit handoffs with fee script and ROF reminder. - Reminder call before arrival. - Reception: patient forms AA/WC, insurance/ID copies, subluxation pamphlet, x-ray card, comment box, portfolio and welcome letter. - Reception: Doctor Use Form to Treatment, insurance to Billing, two labels, NP log, ROF tray and doctor call list. - Enrollment: consult/exam/x-rays, spouse script, ROF form, fees, NP log and financial. - Billing verifies insurance, enters patient/insurance and marks TC. - Treatment documents exam/fees/script, marks films, routes Doctor Use Form to Billing then Day 2 bin. - Ensure ROF time in manual book and reminder sheet given. - Explain actual service values/fees then actual waiver if applicable; source $30+$120=$150 is an example. Workflows: rec-day1-frontdesk, rec-rof-preparation, rec-rof-invitation, rec-quality-fileflow, rec-doctor-calls, rec-referral-reward Scripts: rec-day1-fee Uncertainty: ['The image is slightly soft around punctuation in “Pt.- Copy ins. Card/DL” and “(1st Adj?)”; these are transcribed as they appear.'] Disposition: mapped ### IMG_0254 · ROF booking and patient reminder sheet One-hour results/plan/finances appointment with support-person and child-care preparation. - Book next available with spouse/significant other as agreed. - Provide date/time/presenter and explain results, recommendation, home care and finances. - Allow one uninterrupted hour; invite those helping decisions. - Ask child-care arrangements; source offers staff help if sitter unavailable. - Provide rescheduling number; retain historical contact in source only. Workflows: rec-rof-invitation Scripts: rec-rof-reminder-sheet Uncertainty: [] Disposition: mapped ### IMG_0255 · Day 2 ROF: group and individual variants ROF checklist, absent support-person branch and clear Day 3 handoff. - Confirm by preceding shift; group board clean, films/model ready. - Sign in; if agreed support person absent call them, then Enrollment chooses rebook or defer finances. - Group one How to choose chiropractor pamphlet/person; first arrival seated 6:05pm front-wall row. - Single ROF uses three pamphlets: Degeneration, Types of care, Nerve function. - Enrollment: ROF, financial, policies signed, calendar, family and Day 3, collect fees; money/plan on TC/computer/NP log. - Doctor adjustment as appropriate; Reception first-adjustment call list. - Collect referral cards, book Day 3 with Enrollment, give doctor contact if adjusted, complete call list and Day 3 bin. Workflows: rec-reminders, rec-group-rof, rec-private-rof, rec-day3, rec-quality-fileflow, rec-doctor-calls, rec-family-invitation Scripts: rec-doctor-cell Uncertainty: ['The quotation beginning before “The doctor has asked me...” has no visible closing quotation mark after “concerns.”'] Disposition: mapped ### IMG_0256 · Day 3 reception and Enrollment wrap-up Arrival notification, signed papers, flow/rehab and calendar delivery. - Sign in/seat and notify Enrollment. - Enrollment ensures signed paperwork, office flow, rehab and equipment. - After adjustment collect instructed fees. - Give white multiple-appointment calendar copy and enter computer. - Place completed file in Quality bin. Workflows: rec-checkout, rec-day3, rec-quality-fileflow, rec-rehab-handoff Scripts: Uncertainty: [] Disposition: mapped ### IMG_0257 · Arrived-patient referral reward system Patient/business thank-you ownership tied to actual referral arrival. - At Day 1 determine referral source. - For patient referrer create alert on their file; for business notify office manager. - Put referrer contact on doctor call list. - Give appropriate gift and source thank-you. - Write arrived referral name bottom-right on referring patient travel card. Workflows: rec-doctor-calls, rec-referral-reward Scripts: rec-referral-thanks Uncertainty: [] Disposition: mapped ### IMG_0258 · Travel card key: Reception and Enrollment Paper data model: identity, attribution, commitments, payments and Day 1/2/3 milestones. - Patient completes back to Office Use Only on Day 1; label front top right. - Record referral source, charge/waiver and insurance in referral box. - Record arrived referrals bottom right. - Reception owns CAL column regardless of who created it. - Payments red; monthly due circled and crossed when automatic-payment report confirms receipt. - Date each visit; numbering starts second line because many Day 1s are not adjustments. - Enrollment records Day 1 and scheduled Day 2/3 dates, circles when performed, writes changeable payment arrangement in pencil. Workflows: rec-calendar, rec-arrival, rec-day1-frontdesk, rec-referral-reward, rec-otc-payments, rec-billing-limits, rec-insurance-change Scripts: Uncertainty: ['The final sentence is cut off in the image after the visible word “payment”; no continuation is supplied.', 'Sentence continues into IMG_0259; do not treat cropped text as missing procedure.'] Disposition: mapped ### IMG_0259 · Travel card key: payment completion and insurance limits Continuation defines Billing benefit fields and full/half blue coverage lines. - Reception crosses circled month when payment occurs. - Initial calendar written CAL area by Enrollment or Reception. - Billing records primary/secondary benefits and plan-year/calendar-year basis. - Document authorization/ACN/other billing notes. - Full blue line marks last covered visit; half line marks requestable-extension point; new line after approval. - Treatment division heading appears without substantive continuation on this page. Workflows: rec-calendar, rec-otc-payments, rec-billing-limits, rec-insurance-change Scripts: Uncertainty: ['The visible opening begins mid-sentence at “goes through”; no preceding words are visible, so none have been supplied.', 'Faint reverse-side printing and form-like marks are present; their wording is [illegible].', 'No marginal writing is confidently legible.'] Disposition: mapped ### IMG_0260 · Front Desk Manager checklist duplicate Another copy of the front-desk performance sheet with printed page 5. - Start team huddle on time with required people; retrieve/distribute messages. - Before lunch: pull travel cards, call misses, clear Pending, transfer phones, review misses with doctor. - End of day: doctor call list on counter, NP log current, cards pulled/books printed, misses called and missed Day 1 in NP Missed Log. - Verify live M–F 8–5 phone coverage, clear Pending, review doctor misses and reconcile Cash Practice/payment log/payments/receipts. - Record reactivations, prior/current-week PV and petty cash by day. - End week: next quota graph/battle plan and Saturday printout. - Friday gap = next-week PV target minus booked visits plus 10% target; submit completed sheet to Division 7 and state help needed. Workflows: rec-phone-coverage, rec-recall-lists, rec-missed-onboarding, rec-doctor-calls, rec-cash-drawer, rec-frontdesk-shift, rec-weekly-targets, rec-collections-ledger Scripts: Uncertainty: ['Faint show-through is present, but no words are confidently readable; recorded as [illegible].', 'The two curved marks at the left margin do not appear to be readable text.'] Disposition: duplicate ### IMG_0261 · Signed Day 1/2/3 routing form and Quality gate Detailed division signatures and exact file states prevent handoff loss. - Day 1 Reception sign-in/insurance/ID/forms; computer demographics; pamphlet/TC/labels/x-ray/file; notify Enrollment; portfolio left counter; verification Div3. - Day 1 Reception fees/NP log/call list/ROF book and file above x-rays; signature. - Enrollment consult/laundry list, doctor exam, ROF sheet, TC fees/date, x-rays, reception handoff, financial/NP log; signature. - Doctor marks TC films/diagnosis/plan; Billing verifies/enters insurance/services/DX/modifiers/injury date; signatures. - Day 1 file: x-ray bin → NP tray → services entered → to be filed → Day2 scheduled/not scheduled. - Day 2 Reception sign/pamphlet/date TC/ROF slot; fees/referral card/doctor contact/Day3/entry stack/call list. - Enrollment confirms ROF, financial readiness and whether given, clinician adjustment handoff and TC; Billing enters services/DX/injury date. - Day 2 file: Day2 scheduled → portfolio → entry → filing → Day3 scheduled. - Day3 Reception sign/seat, fees/family/MAP in computer; Enrollment MAP/policies/financial/family/flow/NPlog/TC. - Billing completeness: demographics/insurance, TC marks, NP log, case ready and all services to date. - Quality checks TC/NPlog/MAP with LA/computer ready; only then separate file and TC; TC bin, file scan. - Record rehab shown, equipment given and picture. Workflows: rec-day1-frontdesk, rec-rof-preparation, rec-group-rof, rec-day3, rec-quality-fileflow, rec-doctor-calls, rec-otc-payments, rec-billing-limits, rec-policies-consent, rec-family-invitation, rec-rehab-handoff Scripts: Uncertainty: ['The repeated Day 1 and Day 2 checklist glyph is euro-like in appearance; it is represented as € and not interpreted as a checked or unchecked box.', 'The third Day 2 Enrollment checklist row contains only the printed checklist glyph; no accompanying text is visible.', 'Faint reverse-side show-through is present, but its fragments are not confidently readable.', 'The first blank in the Rehab line, after “Exercises are shown,” appears darkened; no value is readable.'] Disposition: mapped ### IMG_0262 · Doctor call list template and communication return path New patient, first-adjustment and rush callbacks with referral and next-visit context. - Reception fills throughout day and delivers counter at end of day. - NP fields: patient contact, referred by/contact, ROF date/presenter and adjusted status. - First-adjustment fields: cell/home/email and next appointment. - Rush fields: name/contact, reason and last visit. - Treatment reports communication progress; Reception routes to correct department. Workflows: rec-doctor-calls Scripts: Uncertainty: ['Faint show-through is visible behind the foreground printing, but no words can be read confidently: [illegible].', 'Text partially visible at the right edge on an adjacent sheet is [illegible].'] Disposition: mapped ### IMG_0263 · Ouch: new injury prompt Repeated mini-form captures whether new event belongs to work or auto case. - Ask if work-related. - Ask if automobile accident. - Capture patient description of what happened. - Route injury context to clinician/billing before routine flow. Workflows: rec-arrival, rec-auto-intake, rec-workers-comp Scripts: Uncertainty: ['Faint show-through is visible through the paper, but no words can be read confidently.', 'The far-left fragments are cropped and appear to belong to the adjacent page; only `?` and `visit.` are readable.'] Disposition: mapped ### IMG_0264 · Daily sign-in sheet Dated attendance form with forty numbered name lines. - Record clinic/date and one name per line. - Use attendance to reconcile arrivals with appointment book. - Modern public proposal should not expose actual patient names. Workflows: rec-arrival Scripts: Uncertainty: ['Faint text shows through the paper, but no words can be confidently read.', 'The adjacent-page fragments are cropped; their missing portions are not reconstructed.'] Disposition: mapped ### IMG_0265 · Enrollment owner’s daily priorities Follow missed onboarding, prepare financials, finish files and audit re-sign opportunities. - Track/call missed Day 1 and Day 2. - Perform available Day1 consultations and prompt next ROF. - Expedite verified insurance before financial. - At ROF complete calendar/policies if time; otherwise Day3 with same Enrollment owner, or other staff for flow/rehab only. - Complete outside-file checklist and eliminate unresolved Day2/3 stacks. - Review travel-card bin for active/pay status and re-sign opportunities; resolve barriers. - Free-time priority new patients → ROFs → paperwork. - Record collected money for bonus. Workflows: rec-reactivation, rec-missed-onboarding, rec-day1-consult, rec-day3, rec-financial-audit, rec-enrollment-shift, rec-family-invitation, rec-plan-end-review Scripts: Uncertainty: ['The handwritten label on the green tab appears to read “Enrollment.”'] Disposition: mapped ### IMG_0266 · Enrollment training and competency checklist Twenty-four observed competencies with senior signature and four-week performance demonstration. - Review expectations, tour/meet staff/desk/manual, read and sign policies. - Know Primary Script and schedule three NPIs from survey/card/massage sources. - Learn six organizational terms and five condition formulas; perform Non-existence formula. - Explain TC duties and pass full Day1, financial paperwork/verbal, Day3 and rehab. - Pass C2/T2/L2 imaging within scope; missed-stage and reception/recall phones. - Complete NP log/checklist; pass Room4 and re-exams; privacy certification. - Explain preconditions to separate file/TC. - Set OTC/Day1/2/3 graphs; demonstrate NORMAL graph four weeks; senior dates/signs. - Footer has completed Non-existence/Danger and no longer bypassed checks; cropped labels remain uncertain. Workflows: rec-quality-fileflow, rec-training, rec-marketing-call, rec-rehab-handoff Scripts: Uncertainty: ['The beginning of the first top-row label is cut off; only “te passed off” is visible.', 'The beginnings of the three lower-left footer lines are obscured or cut off; the visible text is transcribed with [cropped].', 'The footer boxes appear to be empty checkboxes.'] Disposition: mapped ### IMG_0267 · Financial creation and audit math Insurance plus clinician plan feeds four payment paths and expected-versus-paid audit. - Reception gathers insurance; Billing verifies; doctor writes plan on TC; Enrollment assembles financial. - Source sequence one-time, monthly, three visits, modified; financial after willingness to proceed. - Set agreed auto payments; mark TC/paper/computer. - Audit covered visits, deductible visits at source $55, cash visits at $55, exams/x-rays, total should-pay, original deal, amount paid and balance. Workflows: rec-rof-preparation, rec-financial-options, rec-three-visit-review, rec-billing-limits, rec-financial-audit, rec-plan-end-review, rec-insurance-change, rec-discontinuation Scripts: Uncertainty: ['A small curved handwritten mark appears beside “What is owed now?”; it contains no readable wording.', 'Faint mirrored show-through from the reverse side is visible but not reliably transcribable.'] Disposition: mapped ### IMG_0268 · Enrollment manual contents Sixteen chapters enumerate responsibility, conditions, stats, phones, new patients, finances, tracking, imaging, prep, expectations, Day1/2/3, re-exams, Room4 and accidents. - Use contents as section-coverage checklist; chapter headings do not supply unseen rules. Workflows: Scripts: Uncertainty: ['Faint reverse-side show-through is visible, but no complete words can be read confidently.', 'Text cropped along the left edge appears to belong to another page and is not reliably legible.'] Disposition: reference ### IMG_0269 · Enrollment daily metrics and readiness sheet Audit, funnel, re-sign and money measures with next-day prep and alphabet audit tracker. - Arrive prepared for manual-book appointments. - Count audits, audit meetings, Day1 booked/performed, ROF, re-signs, starts/start% and each missed-stage recovered. - Record daily/weekly OTC. - Mark travel-card audit alphabet coverage. - End day finances/films ready, Day1/2 tomorrow reminder calls done, NPlog/checklist accurate. - Next-week graph/plan ready; submit to Div7 with help request. Workflows: rec-reminders, rec-missed-onboarding, rec-rof-preparation, rec-financial-audit, rec-enrollment-shift, rec-weekly-targets, rec-collections-ledger, rec-plan-end-review Scripts: Uncertainty: ['Faint reverse-side show-through is visible, but no complete words are confidently readable; it is marked [illegible].', 'The mark before “Next week’s quota graph...” is unclear; it resembles a symbol or handwritten mark, so it is not identified as a specific character.'] Disposition: mapped ### IMG_0270 · Enrollment performance expectations and ten-minute rooming Care-stage completion, preparation, quality routing and manager summary controls. - Daily checkoff/notations; weekly manager mailbox. - Ready for staff meeting; room Day1/2/3 within ten minutes of paperwork/pamphlets. - NP checklists complete; next-shift files/films/financials ready. - TC calendars/financials and NP log correct; finished files to Quality Div5. - Family scheduled by Day3; Day3 flow/rehab shown. - Graphs/battle plans visible, compare ROF/collections target, enter stats and missed Day2/3 recovery counts. - Write weekly summary to office manager. Workflows: rec-missed-onboarding, rec-rof-preparation, rec-day3, rec-quality-fileflow, rec-reexam, rec-enrollment-shift, rec-weekly-targets, rec-family-invitation Scripts: Uncertainty: ['Faint reversed text shows through the paper, but no words are confidently readable: [illegible].', 'Cropped marginal/adjacent-page fragments are visible at the far left but cannot be read confidently: [illegible].'] Disposition: mapped ### IMG_0271 · Day 1 expanded consultation and education Patient concerns and quoted life impacts precede exam; contains historical medical/persuasion claims. - Introduce and room patient; ask positive/negative prior beliefs. - Explore main concerns and top two, work/home/hobby impact and patient quotes. - Write laundry list for Day2. - Explain intended clinical assessment; then get doctor. - Archive but do not automate source goal “RUIN,” organ-disease/death claims or promises of help. Workflows: rec-day1-consult Scripts: rec-day1-concerns, rec-day1-education-archive Uncertainty: ['Outline item 4 appears to have an opening quotation mark without a visible closing quotation mark; retained as printed.', 'The closing quotation mark for the first “The doctor will be with you...” passage is not clearly discernible; no closing mark is included.'] Disposition: mapped ### IMG_0272 · Day 1 doctor handoff, ROF booking and fees Clinician receives ranked concerns; findings, imaging and support-person/fee details drive next visit. - Show doctor red laundry list and rank top two. - Doctor exam/findings and reviewed explanation; note findings, films, charges and intended support person on TC. - Take appropriate clinician-ordered x-rays. - Book next available ROF and review one-hour results/plan/finance/home-care handout; solve support-person/child-care logistics. - Explain actual fees or waived service values; source 30/120/150 amounts are examples. - Source final product is desire to return Day2, not proof of clinical benefit. Workflows: rec-day1-consult, rec-rof-invitation Scripts: rec-day1-doctor, rec-rof-invite-spoken Uncertainty: ['The initial letter of “detailed” is partly obscured by the curved mark at the left margin; the printed word appears to be “detailed.”'] Disposition: mapped ### IMG_0273 · Day 2 preparation and commitment conversation Prepared benefits/films/forms; adherence expectations and obstacle discussion before financial. - Insurance verified; films marked/pulled; Doctor Use Form and care/financial forms complete. - ROF scheduled/not-scheduled bins; films ready in room on day. - Explain source punctuality, make-up within seven days, home rehab and health-class expectations. - Ask readiness and obstacles; source repeats until enthusiastic 10. - If not ready, source allows by-stages commitment through first re-exam. - Preserve pressure language in archive; modern delivery must remain voluntary. Workflows: rec-rof-preparation, rec-private-rof, rec-education, rec-rehab-handoff Scripts: rec-commitment Uncertainty: [] Disposition: mapped ### IMG_0274 · Readiness close and private problem-solving preparation Finishes obstacle loop and describes prepared versus unprepared concern meetings. - Ask other obstacles then readiness to start; finances referenced to chapter6. - With time: financial audit, adherence/recommendation comparison, films, notes and informed hypothesis. - Meet patient, address all barriers and concerns. - Without time: inspect TC finances/payments/calendar, recall known context, inquire directly. - If not solvable obtain information and schedule a follow-up. Workflows: rec-private-rof, rec-financial-audit, rec-room4 Scripts: rec-commitment Uncertainty: ['Faint curved marks appear in the left margin; they contain no readable words.', 'Faint show-through is visible on the page, but it is not legible as part of the printed text.'] Disposition: mapped ### IMG_0275 · Day 3 completion criteria Finish agreements, rehab, family invitation and all records. - Signed paperwork and exact financial agreement. - Demonstrate prescribed exercises. - Schedule family checking at source clinic expense. - Complete NP checklist/log, computer notes and TC markings. - Source desires informed commitment to appointments, exercises and referrals; do not imply guaranteed x-ray changes. Workflows: rec-day3, rec-policies-consent, rec-education, rec-family-invitation, rec-rehab-handoff Scripts: Uncertainty: [] Disposition: mapped ### IMG_0276 · Re-exam and re-report operating procedure Visit-count scheduling, feedback form, clinical review, permitted referral request and imaging follow-through. - Re-exams every twelve visits or clinician need; on visit11 book visit12. - At visit12 give Initial Progress Evaluation Form for progress/office/referrals/finances. - Prepare films/calendar/financial awareness. - Review form privately before/after adjustment; repeat positive examination findings appropriately. - Review source four questions and agreed schedule; request specific referrals only with permission before doctor call. - Make notes and route relevant findings. - Source second/third re-exam may include films; next visit re-report must be booked. - Imaging folder to doctor to mark; heel-lift/shoe protocol stays clinician-controlled. - Doctor compares new/old films; doctor-required re-report outside adjusting, trained Enrollment otherwise. - Re-report progress/plan/barriers/referrals. Workflows: rec-reexam, rec-rereport Scripts: rec-reexam-referral, rec-reexam-four-questions Uncertainty: [] Disposition: mapped ### IMG_0277 · Room 4 private concern resolution A distinct workflow for missed visits, money, commitments, calendar and any continuing-care barrier. - Reception rooms patient, pulls films and alerts Enrollment. - Prepared meeting: financial audit, recommendation/adherence, notes/films and possible causes. - Unprepared: TC arrangement/paid/calendar/context then inquire. - Address actual concern and other barriers; if lacking information book follow-up. - Source suggests four commitment questions; keep medical interpretation and voluntary choice clinician-governed. Workflows: rec-special-consult, rec-financial-audit, rec-room4 Scripts: Uncertainty: [] Disposition: mapped ### IMG_0278 · Auto-accident history and historical insurance notes Accident fact capture, effect on life, clinical/billing handoff and old Utah statements. - Ask fault, driver/passenger, occupants, circumstances/weather/road and patient narrative. - Capture prior treatment, work/function impact and perceived accident effect; record all. - Send to doctor and billing; source suggests other occupants checked. - Doctor handles unclear injury/symptom relationship. - Historical PIP/liability/UM/UIM/subrogation/claim-time claims remain unverified reference. - Do not use puppy analogy as causation proof. Workflows: rec-auto-intake Scripts: rec-auto-example-archive Uncertainty: [] Disposition: mapped ### IMG_0279 · Workers comp and post-claim financial transition Employer prerequisites, injury paperwork and new financial when claim coverage ends. - Complete work-comp billing forms and incident narrative. - Ask supervisor report and required Work Med/first provider. - Consult doctor on uncertain pathway. - After Billing has auto/work-comp material finish Day3 paperwork/flow. - When case ends make new financial for continued care. - Archive old Utah 6–12 visit/doctor-change rules and hostile-insurer assertion; do not automate as facts. Workflows: rec-workers-comp, rec-claim-transition Scripts: Uncertainty: [] Disposition: mapped ### IMG_0280 · Enrollment responsibilities, outputs and funnel targets Defines patient relations, initial exam, acceptance and active-patient measures. - Maintain mailing list/letters/gifts/cards/reactivation/newsletter with reactivated count. - Initial consultation/imaging/ROF produces complete history; count well-done exams. - Acceptance includes ROF/financial/log/TC, re-sign, Room4/workshops/pamphlets and finances. - Track treatment-acceptance %, total active patients, NPI, OTC, ROF, starts and re-signs. - Source goals above 70% NPI starts and above 70% re-signs. - Read manual and pass sections as Enrollment Div2. Workflows: rec-reactivation, rec-referral-reward, rec-weekly-targets, rec-training, rec-family-invitation, rec-plan-end-review, rec-patient-relations Scripts: Uncertainty: [] Disposition: mapped ### IMG_0281 · Employee qualities and undefined organizational terms Work hard, work smart and get along; headings for Terms, Org board and Tone scale have no definitions. - Retain three source employee qualities as training context. - Do not invent definitions for blank headings. Workflows: rec-training Scripts: Uncertainty: ['Faint reverse-side text shows through the page but is not legible enough to transcribe reliably.'] Disposition: reference ### IMG_0282 · Shift preparation, supplies, calendar and mailbox Concrete anti-drop measures include next-shift readiness and daily carry-forward of unfinished tasks. - Ready five minutes before huddle; review books before leaving for next shift. - Gather verified insurance/care plans/prior plans/audits/all records for financial. - Stock film/cassettes; process when low; list film/envelopes/tags/developer/fixer on supply door. - Portfolios have spare crisp forms copied only from originals. - No double booking; have a person ready for each patient. - Role desk calendar reviewed daily; mark completion and carry unfinished tasks to next day; covers consult both calendars. - Empty mailbox at least twice per shift. - “3 STACK TRAYS” heading appears without the continuation on this photo. Workflows: rec-rof-preparation, rec-financial-audit, rec-enrollment-shift, rec-supplies, rec-task-handoff Scripts: Uncertainty: [] Disposition: mapped ### IMG_0283 · Private ROF financial branch map Ordered care-plan/payment discussion with different paths for disclosed versus undisclosed financial obstacles. - Discuss support-person beliefs, Day1 learning, pamphlets, films and patient concerns. - Explain appointment/exercise/classes commitments; ask scale, barriers and readiness. - Show care plan then total-cost Financial Summary. - Try one-time then monthly up to twelve months. - If finances discussed, record P&L and find modified arrangement. - If unwilling to discuss after question repeated, offer three-visit trial then sit down after third. - If unresolved, brief doctor privately then bring doctor in. Workflows: rec-private-rof, rec-financial-options, rec-three-visit-review Scripts: rec-private-rof-financial Uncertainty: ['The blank after “you’ve had” is a printed line; no wording is visible in it.', 'The printed list markers are decorative glyphs, represented here as Markdown bullets.'] Disposition: mapped ### IMG_0284 · Patient policies with handwritten amendments Historic payment, insurance, rehab, workshop, discontinuation, family and appointment agreement. - Source one-time 20% bookkeeping discount; credit card/postdated checks for in-house monthly plan; 12-month no-interest then 15%, collections up to 40% plus costs are historical approval-needed terms. - Source rehab twice daily at least fifteen minutes each when prescribed. - Workshops monthly over named health topics; attendance encouraged. - Patient informs insurance changes and auto/work injury; patient responsible for uncovered expenses subject to actual agreement. - On discontinuation source demands balance/repricing rendered services; Care Credit refund clause marked X and unresolved. - Source children within two weeks at doctor expense: retain invitation/consent dependency. - Keep schedule, call about misses, make up within one week; adjust vacations around clinician-approved plan. - Record payment amount/due date/count/paid-through and patient/staff/date signatures. Workflows: rec-calendar, rec-missed-visit, rec-financial-options, rec-policies-consent, rec-education, rec-family-invitation, rec-rehab-handoff, rec-insurance-change, rec-discontinuation Scripts: rec-patient-policies Uncertainty: ['A separate sheet is partly visible along the far left edge. Some text, including a fragment near the top, is [cropped] and obscured, so it is not reliably transcribable as part of this page.', 'Curved handwritten marks appear in the left margin; they do not form readable words.'] Disposition: mapped ### IMG_0285 · Mini Day 2 before full ROF Path for an adjustment on Day1 or before formal results presentation. - Doctor must see films and insurance verification. - Patient in room; doctor notified and briefs findings/adjusts as appropriate. - Confirm or schedule full ROF. - Doctor escorts to desk for next appointment; no full-ROF task lost. Workflows: rec-mini-day2 Scripts: Uncertainty: [] Disposition: mapped ### IMG_0286 · Informed consent and historic risk comparison table Consent form describes assessment before care and includes old numerical risk assertions. - Complete health history/exam before care; assess further testing, modifications or referral. - Report relevant findings and plan before beginning. - Record patient/legal guardian relationship, signatures/date and witness. - Archive old risk figures/table for review; do not treat them as current evidence. Workflows: rec-policies-consent Scripts: rec-informed-consent Uncertainty: ['The separate sheet at the far-left is largely covered and cropped; only the visible labels are transcribed.'] Disposition: mapped ### IMG_0287 · Historical chiropractic versus medical risk handout Comparison table and quotes drawn from older sources; no standalone operational flow. - Retain as source education reference with old citations and inconsistent spelling. - Require evidence/clinical review before any patient use; percentages compare unlike risks and populations. - Do not automate distribution as verified current consent material. Workflows: rec-policies-consent Scripts: Uncertainty: ['The table reference for the esophageal-perforation row is small and slightly distorted in the photograph; it appears to read “Henegouwen ET al., 1991.”', "The final citation visibly appears to spell the author's name “Jaskoviac,” although the earlier paragraph spells it “Jaskoviak”; both forms have been transcribed as printed."] Disposition: reference ### IMG_0288 · Patient Financial Summary form Structured insurance/patient-cost summary with payment-option signatures. - Record medical-necessity visits, primary/secondary insurers, covered visits, deductible/unmet amount and copay×visits. - Separate source chiropractic-necessity visits, re-exams each12, x-rays and total investment. - Source rates 55/30/90 are examples. - Show one-time20% savings, in-house and Care Credit options; signed/date/witness. - Retain Start/Correct/Relief choice fields. Workflows: rec-financial-options, rec-billing-limits, rec-insurance-change Scripts: Uncertainty: ['Faint reverse-side text shows through in several areas of the page but is not confidently readable; it is marked [illegible] and has not been reconstructed.', 'The adjacent page is partly covered and cropped. The weekday and WEEK TOTAL fragments are readable, but their full layout and any repeated instances are not clear.'] Disposition: mapped ### IMG_0289 · Treating doctor: personal readiness and patient review Doctor preparation and intentional patient communication, with progress and calendar reassessment. - Personal coaching: before M/W/F bed10pm/wake5:30, exercise/food, goals read3×day, visualization/audio/mantras and course correction. - Keep card for TC problems, concerns/callbacks and missing patients. - Know patient expectations, TC correction and clinically appropriate care. - Source expects early progress within first3 visits; doctor reassesses technique/frequency when progress inadequate. - Check calendar every visit; uncertainty or unresolved agreement/progress → special consult. - Referral discussion depends on real patient experience; do not promise miracles. Workflows: rec-doctor-calls, rec-doctor-delivery Scripts: Uncertainty: ['The word is legible as “lul” in the image. Whether the author intended “lull” cannot be determined from the image.'] Disposition: mapped ### IMG_0290 · Treating doctor: end-of-shift review and efficient patient flow Doctor joins missed-visit accountability and prepares films/flow; contains non-evidence-based ideology. - Review missed names with Reception every shift, especially unmarked outcomes/unknown status. - Prepare films and conversation before shift. - Teach appropriate table/card/number return and exercise flow. - Source personal calls/visits/referral help are examples of care, not automatic visit commitments. - Organize time or adjust hours so patients do not wait and work fits planned days. - Archive claims dismissing medicine/drugs/surgery; do not deploy as medical advice. Workflows: rec-doctor-calls, rec-frontdesk-shift, rec-doctor-delivery Scripts: Uncertainty: ['There are faint curved marks in the left margin and faint show-through on the page; neither is legible printed text.'] Disposition: mapped ### IMG_0291 · Continuous education: handouts, table topics and monthly talks Doctor-owned recurring education plan and progress messaging. - New source handout M/W/F. - Daily table topic often linked to handout; discuss progress and remaining work. - Teach one monthly talk from Orientation/Nutrition/Exercise/Stress-Time Management. - Preserve historical anti-medical claims for review only; approved education must respect evidence and patient-reported outcomes. Workflows: rec-education, rec-patient-relations Scripts: Uncertainty: [] Disposition: mapped ### IMG_0292 · Treating doctor daily, weekly and end-of-shift expectations Visible checklist makes preparation, treatment, missed-appointment reconciliation, call-list closure, billing and weekly planning accountable. - At 7:25 arrive mentally and physically prepared; have the weekly handout; room, quota graph and battle plan ready. - Call the doctor list and return it to reception with notes. - During adjusting hours mark adjustments, table talk, committed calendars, SOAP and travel cards. - Monday ask referrals and record the count; Wednesday identify needed re-exams; Friday recommit next week. - During empty periods train, study, mark films and practise skills while staying available. - Use a 3x5 card or other tracking system for quality control; record referral requests. - At each shift end review missed visits with reception and take action; keep quota graph and battle plan visible and current. - Before leaving mark all films, complete Dr. Use forms, handle calls Divisions 1 and 2 cannot handle, and finish Dr. Call List. - Tuesday review every auto-accident/work-comp account with billing and take action; sign all reports. - Record weekly patient-visit condition; send weekly summary to Quality Control Division 5; prepare next week graph and battle plan before leaving Friday. - Know responsibilities, set dated goals, read them three times daily, visualize the ideal scene, write action steps and track stats. Workflows: care-doctor-day, care-doctor-call-list, care-billing-review, care-quality-capture, care-weekly-rhythm, care-doctor-training, care-film-marking, care-visit-documentation Scripts: Uncertainty: ['The checklist glyph before the items under “End of week action steps” and “Tips” is €-shaped; it is transcribed literally as € without interpreting its meaning.'] Disposition: mapped ### IMG_0293 · New doctor competency checklist and signoff Fourteen chapter competencies plus practice-value agreement are assessed before the doctor is considered trained and the signed record is filed. - Read and agree to Practice Values Guide, Team Job Description, Performance Expectations and office policies. - Master primary script; calls to inactive patients, stress surveys and PGCs; travel-card markings; Day 1 exam; mini Day 2 and first adjustment. - Demonstrate re-exams and re-reports; taking/marking films, processor chemistry and Dr. Use Form; rehab instruction and adherence. - Demonstrate table talk, flow and commitments sufficient to increase weekly patient visits; orientation/ROF; reports and case documentation with weekly billing meeting. - Understand conditions/formulas; have visible written growth battle plan; understand Post, Hat, Hatted, Product Statistic, Graph and Ethics. - Senior signs and prints name with completion date when the doctor is no longer being bypassed; file signed form in employee file. Workflows: care-doctor-training, care-imaging-training, care-rehab-adherence Scripts: Uncertainty: [] Disposition: mapped ### IMG_0294 · Primary script: concern to booked evaluation Full persuasion and appointment-selection script, with receptionist handoff data. - Memorize the primary script and perform it naturally. - Ask what health problem concerns the prospect; invite elaboration, duration, worst severity and impact on work/life. - Ask permission to explain chiropractic; use the source rock-in-shoe analogy and conditional evaluation invitation. - Offer morning/afternoon, then next two appropriate blocks, then two times; ask whether any reason prevents keeping the appointment. - Give reception name, phone and referral source for appointment entry. Workflows: care-primary-booking Scripts: care-primary-script Uncertainty: ["The title's leading printed symbol appears to be δ, though the small glyph is not perfectly clear.", 'The parenthetical ends with a question mark followed by several dots; the image appears to show four dots.', 'Medical mechanism and drug-withdrawal passages require clinical review; preserve them as historical source, not automatic advice.'] Disposition: mapped ### IMG_0295 · First-adjustment callback and doctor call-list loop Reception captures first visits, referring parties and special situations; doctor calls that evening and returns annotated outcomes next day. - After first adjustment place name and phone numbers on Dr. Call List; doctor calls before leaving to ask response. - If good, acknowledge and confirm next visit; if bad, source supplies a detox explanation plus ice/other overnight instructions and next-day appointment, even on closed day. - Reception adds concerns only doctor can handle to Dr. Call List during day. - Doctor calls that night, returns annotated list next day; copies unresolved work for later followup. - Call referring parties to thank them; call first-adjustment patients; handle deaths, births, patients wishing to stop and other special situations. Workflows: care-first-adjustment-call, care-doctor-call-list, care-referral-thanks, care-first-adjustment, care-adverse-response Scripts: care-first-adjustment-call Uncertainty: ['Detox explanation must not auto-dismiss an adverse event. The 72-hour statement is a source retention expectation, not an outcome guarantee.'] Disposition: mapped ### IMG_0296 · Recognize disengagement and respond during the visit Noticing affect and understanding unmet needs are treated as early retention interventions. - If a patient drops out, call promptly, discover what went wrong and address it. - Review indicators: family never came, no referrals, missed ROF/orientation, little education/value at visits, repeated unaddressed missed visits, no followup call, painful adjustments or poor symptomatic value. - At arrival notice energy and ask what is going on or whether something is wrong; address grief, bad last adjustment, new accident, stress or other concern. - Show concern and raise tone; give reassurance at exit. - For high energy, greet warmly, check and confirm next appointment. - First adjustment should relieve pain rather than create it. Workflows: care-at-risk, care-visit-loop Scripts: care-energy-check Uncertainty: ['Curved marks are visible in the left margin; they are not legible as words.'] Disposition: mapped ### IMG_0297 · Standard adjustment and returning inactive-patient care choices Four-part visit loop plus a concrete relief-care trial, reassessment and either dormant check-in or corrective-care enrollment. - If adjustment hurts the source says explain scar tissue, advise ice and arrange a near next visit; do not repeat the painful approach. - Discover exactly what patient wants from consultation, travel card or special consultation. - Greet prone patient by name, deliver specific adjustment while explaining findings, give calendar/rehab/home-care instructions and state next visit. - For returning inactive patient, enrollment pulls films, consults in room 4 about auto accident/new injury and reason for returning, then gets doctor. - Doctor reviews films and offers relief or corrective care. - Relief branch: source example M/W/F three visits, reassess Friday; if pain persists request two more visits. - When pain resolves offer symptom-triggered return or continued corrective care. - Relief-only choice means no further appointments; reception records a check-in in unspecified months. - Corrective choice returns to enrollment for finances and calendar. Workflows: care-visit-loop, care-returning-inactive, care-relief-path, care-adverse-response Scripts: care-returning-relief, care-pain-and-visit-steps Uncertainty: ['Care frequency and symptom assessment belong to clinician; month count is blank in source.'] Disposition: mapped ### IMG_0298 · Questions overflow into special consultation Short handoff protects time for answering questions outside adjustment hours. - When patient has many questions, acknowledge each matters and direct reception to schedule uninterrupted time during non-adjusting hours. Workflows: care-special-consult Scripts: care-special-consult Uncertainty: ['The upper left-margin handwritten mark is not readable as text.', 'A second left-margin handwritten mark is only partly visible at the lower left edge.', 'Faint reverse-side show-through is visible but not legible.'] Disposition: mapped ### IMG_0299 · Inactive search queues and differentiated recall scripts Five record searches locate missing patients; three scripts distinguish missed ROF, several missed visits and long absence. - Use available time to search travel-card bin for noncompliance, reverse-order New Patient Log, stalled Day 2/Day 3 slots, unfamiliar inactive files and a date-based absence report. - Missed ROF: doctor calls about planned x-ray findings review and offers morning or afternoon. - Several missed visits: ask whether everything is okay and discover barrier to return. - Long absent: ask about original symptoms; discuss new concerns with primary script; offer no-charge evaluation. Workflows: care-inactive-recall Scripts: care-inactive-recall Uncertainty: ['No numeric inactivity age, retry count or call spacing is given.'] Disposition: mapped ### IMG_0300 · Travel-card technique baseline and billing marks Card stores response-guided technique, transferable key notes, exams/imaging/fees and the next appointment. - At first adjustment write technique/procedures in right-side COMMENT section as response baseline. - If response is good stay with technique; if poor change technique, speed or force; source allows twice-daily visits if needed within first 72 hours. - Circle working combination so it transfers to later cards. - Mark films and exams in their correct place to support billing. - Check calendar is correct and remind patient of next appointment. Workflows: care-technique-record, care-visit-loop Scripts: care-visit-exit Uncertainty: ['The small curved mark in the upper-left margin is not legible as text; it is not included in the transcription.', 'Item 8 visibly reads “take,” not “taken”; the unusual wording has been retained as printed.', 'Clinical adjustments/frequency are clinician decisions; 72-hour improvement is not guaranteed.'] Disposition: mapped ### IMG_0301 · Doctor-led Day 1 consultation and examination Doctor is trained to perform entire Day 1 when enrollment is unavailable, with consultation, exam, imaging, explanation and ROF scheduling. - If doctor runs Day 1: consultation, examination, x-rays, tonight-review script, then ROF scheduling script and paper. - Introduce self in private room; clear positive/negative chiropractic experiences. - Use primary script to discover chief concern, impact on work/home/hobbies and desired health change. - Source discourages x-rays if there is no symptom motivation or understanding of the philosophy. - Explain source subluxation/nervous-system model and refer elsewhere if not a suitable case. - If disc involvement suspected perform sitting Cox tests first, then posture evaluation. Workflows: care-day-one Scripts: care-day-one-consult Uncertainty: ['The exact number of periods in the dotted leader after “these problems?” is difficult to determine from the image.', 'Symptom motivation is not a radiograph indication; clinical necessity must govern.'] Disposition: mapped ### IMG_0302 · Day 1 exam completion and report-of-findings booking Exam results, films, payment handoff and a detailed ROF attendance instruction script continue Day 1. - Palpate spine, explain findings with posters, explain clinically needed films and fees. - Take films and mark travel card with films/exam/fees; doctor states that detailed review occurs tonight. - Ask for spouse/significant other at ROF; book outside adjusting hours. - Fill ROF paper; allow one hour with nothing immediately after; arrive five minutes early. - Ask for babysitter; if that falls through still attend and staff look after child. - Explain shared introductory information then private individual-film review. - If fees due walk patient to reception to collect before release; if none patient leaves with ROF paper. - Train with Day 1 questions covering motivation, enrollment duties, doctor steps, views, fees, spouse and receptionist payment language. Workflows: care-day-one, care-rof-booking Scripts: care-day-one-rof, care-exam-findings-explanation Uncertainty: ['The exact number of periods in the dotted pauses is difficult to distinguish; the transcription follows the visible runs as closely as possible.', 'Childcare capacity and privacy should be made explicit before promising.'] Disposition: mapped ### IMG_0303 · Day 1 training answers: fees, referral-source offers and support person Referral source changes historical fees; the doctor and enrollment roles are scripted and the financial decision support person is identified. - Enrollment handles prior positive/negative experiences, chief symptoms and explanation, then gets doctor. - Doctor greets, acknowledges source, examines, explains findings, films/fees and ROF with spouse/support person. - Source screening films: lateral cervical and AP low back; add views if needed; insurance appropriate series; auto/work-comp all necessary including cervical flexion/extension. - Historical pricing: patient referral free exam only; family within two weeks free exam and x-rays; family later free exam; PGC/health fair free exam, films, possibly massage. - Cash referral script quotes $30 per film; insurance script quotes $30 exam plus $30 each film, collect copay while checking coverage. - Invite spouse/significant other or person needed for financial decisions to ROF; handle objections. Workflows: care-day-one, care-day-one-fees, care-rof-booking, care-family-check Scripts: care-day-one-training Uncertainty: ['The exact printed lengths of the fill-in blank lines are not fully clear; they are represented with underscores.', 'Historical $30 fees/benefits require current approved fee schedule. Clinical necessity controls views. Support-person disclosure requires patient authorization.'] Disposition: mapped ### IMG_0304 · Collect Day 1 fees and strengthen an uncertain return Reception quotes itemized charge and offer discount; doctor calls later that day when commitment to ROF feels weak. - Reception states exam cost, number of $30 films and total, offers cash/check/card, then explains applicable source discount or no cost. - If Day 1 felt weak doctor calls later that day/night after reviewing films and confirms tomorrow time. - Detailed findings questions are deferred to ROF in source. - If invited spouse answers, establish whether patient told them; if aware confirm visit; if unaware get patient and spouse together and confirm shared time. Workflows: care-day-one-fees, care-weak-day-one Scripts: care-day-one-collection, care-weak-day-one Uncertainty: ['The underline blanks are visible; their exact printed lengths are represented approximately with underscore characters.', 'Do not disclose findings/attendance to spouse without permission; do not invent worsened findings or withhold needed informed-consent information.'] Disposition: mapped ### IMG_0305 · Mini Day 2 and first-adjustment explanation If ROF is days away a modified second visit bridges the delay; full Day 2 begins with explanation and response observation. - Normal Day 2 is ROF; when ROF delayed several days, see patient earlier for clinician-directed small first adjustment. - Modified visit uses consultation room and file without films; doctor explains findings and intention to observe response. - After ROF patient prone; doctor asks understanding and explains each adjustment step. - Source target first adjustment is one minute or less; goals are explaining process, brief visit and symptomatic results. - Teach side roll and elbow-assisted rise, including getting out of bed; observe whether better or worse. - Recognize dropout risks: not improving, feeling great and repetitive/bored visits. Workflows: care-mini-day-two, care-first-adjustment, care-at-risk, care-visit-loop Scripts: care-mini-day-two, care-first-adjustment Uncertainty: ['The final mark after “place.” in the Better response is faint; it appears to be a closing quotation mark.', 'Time target does not override assessment, consent or clinically necessary duration.'] Disposition: mapped ### IMG_0306 · First-adjustment response branches and early trial care Continues first-adjustment response loop and records no-adjustment/no-charge, education and trial-care exceptions. - If worse try a different technique; if still not better source gives joint-moving explanation, ice and tomorrow appointment. - If response unclear ask how it feels and use appropriate branch. - Add value by explaining findings, changing clinically appropriate calendar, checking extremities, health talks or special consultations. - If joints holding and symptoms good, no adjustment and no charge; doctor walks to reception, announces outcome/next visit and receptionist congratulates. - Maintain education, patient goals, family/referral participation and reassurance. - Signs of leaving include low energy, no symptom improvement, no family/referrals and repeated unresolved questions. - If only 1–3 trial visits accepted, clinician focuses on experience and response, with calls or changed frequency as appropriate. Workflows: care-first-adjustment, care-no-adjustment, care-trial-care, care-at-risk, care-visit-loop, care-adverse-response Scripts: care-first-adjustment-response, care-no-adjustment Uncertainty: ['The closing quotation mark at the end of the long “Wow everything is still moving...” bullet is not clearly visible; it is not added.', 'Adverse symptoms require clinician assessment, not automatic reassurance or additional adjustment.'] Disposition: mapped ### IMG_0307 · Enrollment barrier rescue, records departure and re-report routing Several distinct failure branches: unable to enroll, travel barrier, departing patient collecting films, and unfavorable comparison-film review. - When enrollment cannot resolve hesitation, get doctor after current adjustment; clinician checks understanding and barrier. - If resolved hand back to enrollment for money/calendar; otherwise offer relief vs corrective care. - Travel barrier goes to manager in room 4 to discuss schedule. - When collecting films to leave: doctor/enrollment/manager privately discovers concern, tries resolution, reviews films if unresolved. - Source says leave film markings on for good terms; erase them if patient is negative; preserve this as historical text requiring records-policy review, never as an enabled action. - Obtain signed film release, document file, archive file, remove future computer calendar and add notes. - RR initially booked during adjusting hours; favorable comparison may be delivered by doctor or enrollment; unfavorable comparison must be doctor outside adjusting hours. - Anyone confused about films must obtain knowledgeable clarification. - Relief trial uses M/W/F then Friday reassessment, two extra visits if still painful and renewed choice once symptoms resolve. Workflows: care-enrollment-barrier, care-distance-barrier, care-departure, care-re-report, care-relief-path Scripts: care-barrier-rescue, care-distance-barrier Uncertainty: ['Image visually rechecked: the erasure instruction is genuinely printed; records must remain preserved in modern proposal.'] Disposition: mapped ### IMG_0308 · Relief-only closure and Day 2 handoff meanings Explains how enrollment signals whether a patient accepted the program or only a three-visit trial, then closes relief-only and corrective branches. - Relief only: stop routine bookings; reception creates a future check-in in blank number of months. - Corrective: meet enrollment for finances/calendar. - Unqualified handoff to adjustment means program accepted with finances being worked out; adjust and walk to front or return to ROFer. - Explicit next-three-visits handoff means testing the practice; explain actions/results and reassess after trial before correction/prevention decision. Workflows: care-relief-path, care-trial-care, care-first-adjustment Scripts: care-relief-closure Uncertainty: ['Month count unspecified; 72-hour persuasion/outcome expectation is not a guaranteed clinical result.'] Disposition: mapped ### IMG_0309 · Visit-count re-exams and comparison-film milestone First 12-visit re-exam uses initial progress report and review questions; later visit milestone starts imaging/re-report pathway. - Reception and doctor recognize grey line every 12 visits; pull films before shift. - For first re-exam give Initial Progress Report before adjustment and attach to travel card. - After adjustment bring patient and films to exam room; doctor covers if enrollment unavailable. - Review every progress-report issue before visit ends; repeat positive tests. - Ask four review/commitment questions; explore barriers if commitment below 10. - Review rehab/heel lift, ask referrals and appropriate testimonial. - Mark #2 in exam section and circle RE in comments; patient returns card to reception. - For second/third re-exam repeat positive tests, clinician chooses films, marks exam and circles RE3, then imaging and reception RR scheduling. - Source says 24–36 visits but also before card end or 35th visit. Workflows: care-re-exam, care-comparison-imaging, care-rehab-adherence Scripts: care-re-exam-questions Uncertainty: ['The prefatory printed glyph before “I am” is visible but not identifiable with confidence; it is rendered as [illegible].', 'Image rechecked; 35th versus 36th-visit wording conflict is present in source and needs approved threshold.'] Disposition: mapped ### IMG_0310 · Re-exam triggers and re-report outcome conversation Re-exam may also respond to disengagement; comparison-film report has separate improved and worse branches. - Re-exam every 12 visits or when patient slipping; can be at table or private room. - Repeat positive tests, measure progress, review four questions, adherence and barriers; referrals/testimonials only if improving, recommendations otherwise. - Source imaging cadence: 2–3 months/24–36 visits; when more information needed; monthly patients every 12 visits/year. - RR measures/shows progress, recommits and requests referrals. - Improved films: compare initial and current views, ask observations, discuss measured percentage change and new clinician-set schedule. - Worse films: first verify markings. Workflows: care-re-exam, care-comparison-imaging, care-re-report Scripts: care-re-exam-practice, care-re-report-improved, care-re-report-worse Uncertainty: ['All imaging cadence and percentage claims require clinician validation; no universal auto-order.'] Disposition: mapped ### IMG_0311 · Worse comparison films: quality checks before explanation Continue unfavorable-film branch with positioning/marking verification and clinician discussion. - Check positioning as well as markings. - If either incorrect, remark or retake as clinically appropriate and do RR next visit. - If technically correct, source suggests rehab nonadherence and temporary worsening explanation; clinician must assess cause. - Source says first followup film at least two months because first 30 days may look worse. Workflows: care-re-report Scripts: care-re-report-worse Uncertainty: ['A small vertical mark at the far right near the final bullet is not clearly identifiable as a printed page number.', 'Do not automatically blame adherence or characterize deterioration as normal. Retakes require clinical justification.'] Disposition: mapped ### IMG_0312 · Film marking work queue and comparative review readiness New films are marked by day end and second set placed in original folder; unclear comparison escalates before the appointment. - New films go in NEW PATIENTS–TO BE MARKED top slot; mark throughout day and before leaving. - AP cervical: atlas and dominant subluxation listings; lateral cervical: atlas angle/proper curve. - AP thoracic: wedges, scoliosis Cobb angle and listings. - AP lumbar: sacral-base and femur-head lines and relationships; sacral rotation at S2 with side difference circled; wedged vertebra endplate lines/listings. - Lateral lumbar: base angle, spondy/retro vertebrae; record additional necessary marks, anomalies, pathologies and fractures. - Source second set 24th or 36th visit/2–3 months; only views needed for comparison rather than full set. - Use original film folder; carefully mark comparisons; ask Dr. Thomas before appointment if changes/explanation unclear. - Complete Dr. Use Form. Workflows: care-film-marking, care-comparison-imaging, care-re-report Scripts: Uncertainty: ['A separate sheet is visible at the far right, but its text is cropped and is not part of the transcribed page.', 'Marking schemes are clinical reference, not automated diagnoses.'] Disposition: mapped ### IMG_0313 · Radiography and film-processing glossary Definitions for views, anatomical regions and analog-film equipment; reference for training rather than a patient sequence. - Learn AP, lateral and oblique orientation and cervical/thoracic/lumbar/sacral/iliac/pelvic terminology. - Learn cassette sizes, bucky, film, extremities, processor, developer, fixer, wash and dryer. - Source processor takes 90 seconds; verify against actual equipment. Workflows: care-imaging-training Scripts: Uncertainty: [] Disposition: reference ### IMG_0314 · Six-view radiography positioning checklist Analog equipment setup, exposure and view positioning are documented as trained-operator reference. - Learn six basic AP/lateral cervical, thoracic and lumbar views. - Check pregnancy, remove shoes/metal and gown if needed. - Put cassette white side out/tag top; position patient; measure and use wall chart; set machine; align beam/body/film; final patient at bucky. - Hold PREP while watching patient through window, then exposure; store used cassette behind lead wall white side out; stack completed green side out with name tag. - Lateral cervical 8x10 beam middle neck, film centered; AP cervical same setup with patient turned toward beam and jaw dropped. - AP thoracic 14x17 top one inch above C7, center beam and hold inspiration; lateral same with turned patient, crossed arms. - AP lumbar 14x17 beam one inch below top hips, center bucky; lateral same with turn toward wall and arms crossed. Workflows: care-imaging-acquisition, care-imaging-training Scripts: Uncertainty: ['The final punctuation after “chest” in the Lateral Lumbar instruction appears doubled in the image; transcribed as “chest..”.', 'Original image and six labeled diagram arrows inspected; diagram is retained with source. Machine-specific steps must be reviewed by trained radiography lead.'] Disposition: mapped ### IMG_0315 · Analog processor startup, processing and maintenance Film tagging and processing loop plus monthly cleaning and exception handling. - Switch processor to DAY on arrival: about 20-minute first warmup, 5–10-minute subsequent warmup; NIGHT before leaving. - Lights off/door closed; tag with name/date/sex/age/exam on flasher. - Open cassette, align corner to stopper/tabs, hold with left hand and flash with right for one long or two short red flashes. - Feed processor, reload cassette with new film, place cassette on left floor; wait beep before next film. - Dr. Thomas trains maintenance; drain/clean monthly. - This page says refill at one gallon; if films wet change fixer; watch tanks. - If noise/stuck films/fault, protect films/boxes before light, remove cover and investigate under trained procedure. Workflows: care-film-processing, care-processor-maintenance Scripts: Uncertainty: ['Image confirms one-gallon threshold; next page says two gallons. Equipment instructions are historical.'] Disposition: mapped ### IMG_0316 · Developer and fixer refill recipe and low-level escalation Analog chemistry recipe adds five gallons, with tank layout and an air-lock escalation. - Developer right/fixer left; both have A and B parts and tank gallons marked. - This page specifies level two gallons: add all A, a couple gallons water, all B, then water to seven-gallon line (five added). - Avoid splashing/staining. - If tank too low and draws air, call Dr. Thomas. Workflows: care-processor-maintenance Scripts: Uncertainty: ['Image confirms two-gallon threshold conflicting with one gallon on preceding page; use manufacturer and trained-lead review before adopting.'] Disposition: mapped ### IMG_0317 · Imaging patient safety, labeling and post-image routing Fourteen-step imaging and file-handling procedure ends differently for new and established patients. - Ask possibility of pregnancy and get doctor if yes; source contains 10-day-period/negative-test exception requiring current policy review. - Remove shoes/jewelry/belt/metal; face patient by view; measure thickest part; set time/KV/MA. - Align crosshairs/body/film; cervical top teeth level; hold still/no breath; hold prep then exposure. - Separate used white-side cassettes from green; stack left processor green side up with patient flasher card. - Mark films on travel card. - New patient dresses and waits for doctor; existing patient is handed with travel card to CA1 for RR booking. - New films: surname-first/date envelope on NP shelf; existing films: original folder on RE shelf. - Distinguish Auto, Work Comp and Regular envelopes; file alphabetically. Workflows: care-imaging-acquisition, care-film-filing Scripts: Uncertainty: ['Pregnancy exception is historical, not an automatically usable safety clearance.'] Disposition: mapped ### IMG_0318 · Rehabilitation instruction and home adherence Six exercise/equipment types with source dose examples and home schedule are preserved as clinician reference. - Source recommended rehab after adjustments and 5–7 days/week at home, 10–15 minutes morning and night. - Head weights: typical source starting men 4lb/women 2lb but amount chosen by head response; in motion on wobble/walking/vibe plate, eyes forward not reading. - Wall traction: work toward 50–60 reps, source says 10–20lb usually sufficient. - Wobble uses V pattern. - Wedge after traction, source 10–15 minutes morning/night; Deneroll package instructions. - Shoulder weights low shoulder; foam wedge as Deneroll or sideways for scoliosis. - Clinician instructs and checks adherence. Workflows: care-rehab-adherence Scripts: Uncertainty: ['Weights, reps, exercise indications and disc claims require individual clinical prescription; retain source values but do not auto-prescribe.'] Disposition: mapped ### IMG_0319 · Treating-doctor schedule and huddles Detailed day reserves adjusting blocks, special consultation/call blocks and handoff preparation. - M/W/F and Tue PM schedule: 7:25 front desk, 7:30 huddle; 7:55 begin; 8–11 adjust/educate/films/Day1/2. - Huddles ensure responsibilities, films, finances and rooms ready. - During adjusting note travel-card/patient issues, set SCs, mark films in gaps, record actions on 3x5. - 11–12 SCs in 10–15-minute slots, calls/minimal paperwork; lunch 12–1; calls/SCs 1–2:30. - 2:30 huddle; 2:55–6 afternoon adjusting block. - Before leaving mark films, complete Dr. Use Forms to Billing, pull next-shift films, complete call list. Workflows: care-doctor-day, care-special-consult, care-film-marking Scripts: Uncertainty: [] Disposition: mapped ### IMG_0320 · Doctor preparation and early-result retention routines Personal preparation is paired with problem capture, early-response checks, calendar adherence and missed-visit reconciliation. - Source personal routine: sleep by 10 before M/W/F, rise 5:30, exercise and energy-supporting meals; write/read goals three times daily and visualization/tapes/mantras. - Use 3x5 for improvement ideas, travel-card problems, concerning patients and absent patients needing calls. - Know chief goal from travel card; evaluate symptom response within first three visits. - If inadequate results consider clinician-directed frequency/technique changes. - Invite satisfied patients to tell others/referrals. - At each visit check appropriate calendar/adherence; if agreement or improvement uncertain book SC to listen, teach and recommit. - Source recommends extraordinary personal support if needed, including calls, home visit or helping find provider for family elsewhere. - At end of each shift review missed visits with receptionist and investigate names lacking disposition. Workflows: care-doctor-day, care-quality-capture, care-trial-care, care-at-risk, care-visit-loop, care-special-consult Scripts: Uncertainty: ["The mantra example's closing quotation mark is not clearly visible; the image appears to show no closing quote before the parenthesis."] Disposition: mapped ### IMG_0321 · Time discipline, patient flow and community presence Preparation and defined consultation blocks support retention, while community outreach builds referrals. - Keep adjusting and SC work in allocated blocks; lack of SCs may mean overlooked concerns. - Meet local businesses/groups, volunteer, lecture and build community familiarity. - Before shift pull/mark films and prepare explanation. - Follow patient flow: face down, exercises, travel card. - Source urges directive health leadership, friendly professional boundaries and strong medical-system claims; retain as historical training for clinical/content review. - Organize work so treatment days can contain preparation and followthrough. Workflows: care-doctor-day, care-visit-loop, care-community-outreach, care-special-consult Scripts: Uncertainty: ['“No one leaves … unless you tell them” cannot override voluntary patient decisions; anti-medical claims are not approved patient messaging.'] Disposition: mapped ### IMG_0322 · Daily education, weekly rhythm and the action-capture card Specific daily/weekday cadence, short visits, paperclip referral target and first-adjustment expectations. - Teach daily; Monday referrals; Wednesday re-exams; Friday recommit next week. - Choose clinician-directed technique for goals; re-exam every 12 and source comparison films 24–36; ask Dr. Thomas if unsure. - Pay-as-you-go/relief patients are offered next week plan Friday, example three visits. - Source target first adjustment under one minute, others under two: show flow, prone setup, greet/touch, brief findings/education, next appointment exit. - Overflow questions/issues get SC via receptionist. - Start each day with 3x5 card, capture referrals/concerns/testimonials/card problems; resolve at day end and send to Quality Control. - Five paperclips track five referral asks daily; transfer pocket on each ask and record end-of-day count. - Source first-adjustment script lists great/achy/nothing as normal. Workflows: care-weekly-rhythm, care-visit-loop, care-quality-capture, care-first-adjustment, care-special-consult, care-relief-path, care-comparison-imaging Scripts: care-weekly-recommit, care-first-response-expectations, care-focused-visit-handoff Uncertainty: ['The blank after “Good to see you” is a printed underline; its exact number of underline marks is unclear.', 'An opening square bracket is visible before “Many patients”; no closing bracket is visible.', 'Lactic-acid explanation and blanket normalization require review; throughput targets cannot compress clinically needed care.'] Disposition: mapped ### IMG_0323 · Technique reference and no-adjustment exception Detailed clinician-only methods for discs/curves/scoliosis and exercises; do not bill adjustment when none performed. - Disc source sequence: prone sacrum PA/SI drop, pisiform traction, supine double PI short/other/short; without double PI source permits PA side posture without rotation. - Kyphotic neck: source C5/inferior-segment drop/hold, head weight and wedge; hyperlordotic: source C2 PA/IS with drop headpiece. - Anterior-bearing neck technique includes ambiguous “life” and “drip” wording; clinician must consult original and resolve. - Scoliosis: mirror-image methods, cervical curve priority, home mirror stretches, low-shoulder weight, opposite head weight. - Cervical traction source 10–15 pulls at two seconds progressing 50–60; lumbar wobble. - Review travel card each adjustment and choose technique; if joint doing well leave it alone, possibly no adjustment; no charge if none. - Holding adjustment may permit spacing but does not mean completed correction. Workflows: care-technique-record, care-no-adjustment, care-rehab-adherence Scripts: Uncertainty: ['The word before “P-A on T2” visibly reads “drip”; whether this is an authorial typo cannot be determined.', 'Original image checked: “life” and “drip” are printed ambiguities. Technique details are archival clinician reference, not a software treatment selector.'] Disposition: mapped ### IMG_0324 · Efficient visits and question routing Brief focused explanation, preparation and SC/orientation routing; begins attrition-sign list. - Assess comfort and change technique if poorly tolerated. - Source average goal two-minute adjustment; stay organized, use concise explanation and gentle deliberate hands. - If many questions route to special consultation or Wednesday orientation. - Know chief reason, films and adjustment order; patient starts prone; brief greeting/exit with next visit. - Notice missed visits and low energy as warning signs. Workflows: care-visit-loop, care-special-consult, care-at-risk Scripts: care-table-talk-efficiency Uncertainty: ['The punctuation after “life” is faint; it appears to be nine periods, transcribed as such.', 'Unsupported organ/ulcer explanations preserved only as source reference.'] Disposition: mapped ### IMG_0325 · Technique continuity and 72-hour peer consultation Additional attrition signs, technique documentation and an explicit colleague escalation if early symptoms do not improve. - Additional risk signs: no smiles/referrals/family checks/re-exams, nonpayment and source criticism of consulting medical doctor. - Know films/complaints; formulate clinician plan; document first treatment technique. - Next visit compare symptoms and muscle/joint response, adapt; circle effective combination for continuity. - If no noticeable improvement within 72 hours consult another doctor. - Source offers family check including x-rays free, free referred examinations, education about nutrition/health and long-term care. Workflows: care-technique-record, care-trial-care, care-at-risk, care-family-check Scripts: Uncertainty: ['Do not treat appropriate medical care as a dropout fault; free family films require clinical indication and approved terms.'] Disposition: mapped ### IMG_0326 · Treatment objections and same-day issue closure Two authored adverse-response replies, a list of unanswered objections, and requirement to resolve attendance, finances, insurance and pain concerns. - Source headache reply attributes toxins and directs changing adjustment; vomiting reply praises detox and says no change—retain only for clinician review. - Unanswered objections include injured rib/more pain, large provider, child/baby treatment, physician disagreement, stroke, negative friend experience and billing concern. - Source prone-pain handling tells patient to lie down/breathe while doctor sees next patient; requires clinical appropriateness review. - During care address missed visits, financial barriers (enrollment room), insurance difficulty, PIP nearing exhaustion and poor improvement. - Capture every issue on 3x5 and handle before leaving. Workflows: care-adverse-response, care-issue-routing, care-quality-capture Scripts: care-historical-adverse-objections Uncertainty: ['The image shows an opening quotation mark before “When I release…” with no visible closing mark after “gone soon.”', 'The image shows an opening quotation mark before “Why am I in more pain” with no visible closing mark.', 'Unanswered objections have no complete book scripts; do not invent exact author wording. Vomiting/new headache must not automatically be dismissed.'] Disposition: mapped ### IMG_0327 · Training your mouth: treatment explanation and SC handoff Q&A reference links charted technique to patient explanation and moves long conversations into SC time. - Mark Dr. Use Form so information reaches travel card; document and circle effective technique. - Explain clinician approach to neck curve/scoliosis/disc using source exercises/techniques. - Each visit explain findings, instructions and confirm agreement. - Answer concerns directly with eye contact; schedule SC for many questions. - Spine-specialist objection continues on next photo. Workflows: care-technique-record, care-visit-loop, care-special-consult, care-film-marking Scripts: care-treatment-explanations Uncertainty: ['The final visible sentence ends with “so”; no continuation is visible.', 'Source guarantees about avoiding surgery and mechanism claims are not approved for automatic delivery.'] Disposition: mapped ### IMG_0328 · Complaint handoffs and calendar-reduction branches Clinical discomfort, alleged billing dishonesty, low engagement and reduced attendance have distinct responsible-person handoffs. - For patient who says hurt/not returning, source offers Dr. Thomas gentle approach and schedules handoff. - Billing honesty complaint: private room, discover issue, bring manager/appropriate staff, restate concern and hand off ownership. - Low energy: investigate pain or poor improvement, show concern; SC if unexplained; another doctor if current relationship fails. - If calendar reduction said to doctor, discover and resolve barrier. - If reduction said to receptionist, ask temporary this week vs ongoing; temporary book make-up next week; ongoing get doctor or manager privately. - If patient self-changes calendar, SC/room 4 for findings/goals discussion, accept feasible commitment and build. - Doctor confirms calendar with explicit frequency and agreement question; greet new patient appreciatively. Workflows: care-adverse-response, care-billing-complaint, care-calendar-change, care-at-risk Scripts: care-complaint-calendar, care-treatment-explanations, care-new-patient-thanks Uncertainty: ['Do not minimize persistent numbness or serious symptoms; source short replies require clinician review.'] Disposition: mapped ### IMG_0329 · New-patient, consultation and ROF phrase bank Alternative short phrases for goals, previous attempts, finances, participation, care choices and commitment. - Discover problem/reason, reflect it back, ask open questions, draw commitment and discuss finances/calendar. - Source urges grabbing attention, reviewing CA history and never using word “little”. - Ask desired health, previous approach, budget, short/long-term preference and participation; source also offers a doctor home-phone card when committed, requiring current contact-policy review. - ROF includes expected time, monitoring, calendar, affordability and relief vs stabilization choice. Workflows: care-day-one, care-orientation-rof Scripts: care-new-patient-phrases Uncertainty: ['Phrase bank contains promotional/clinical promises; retain complete source for review, not automatically approved template.'] Disposition: mapped ### IMG_0330 · ROF phrases and table-talk triggers Short phrase library includes third-visit understanding check and weekly cues. - ROF examples give initial daily or three-times-weekly/12-week plans, finances, teamwork and family invitation; actual plan clinician-set. - Third visit ask what word patient recalls; if unclear do mini report. - Monday reference four referral cards, Wednesday re-exam, Friday recommit. - At visit explain findings, next-visit value, time needed and patient role; practise concise phrases. Workflows: care-orientation-rof, care-visit-loop, care-weekly-rhythm Scripts: care-rof-table-phrases Uncertainty: ["A lowercase-looking “p” is visibly printed immediately after the question mark in “We better talk $ don't you think?p”; its intended meaning is unclear.", 'Historical treatment frequencies and avoid-medical claims require review. Referral four-card cue differs from five-daily-request target and is a different metric.'] Disposition: mapped ### IMG_0331 · Greeting, reactivation and end-of-adjustment phrases Continuation phrase bank with welcome-back without blame and explicit next-visit/attendance language. - Keep visit conversation on relevant health/lifestyle subjects; practise concise source phrases. - Greet warmly; returning inactive patient is welcomed without chastisement. - End with next visit, discuss missed attendance, referral invitation and thanks. - Payment and indefinite-care concern replies are included as exact source phrases for review. Workflows: care-visit-loop, care-returning-inactive, care-calendar-change Scripts: care-greeting-exit-phrases Uncertainty: ["The printed underline after “We'll check you on” is visible, but its exact length is unclear.", 'Blank next-date field stays variable; historical blame/medical mechanisms are not approved messaging.'] Disposition: mapped ### IMG_0332 · Objection phrase bank and new-prospect greeting Many concern/price/commitment responses, plus accepting a feasible attendance frequency and greeting an unfamiliar person. - Source duration example: focus this week and re-evaluate in 4–6 weeks; several alternative long-term-care responses. - If cannot handle three visits ask feasible number and accept two in example. - Address appointment commitment, payment and questions with source phrases; clinician assesses pain and concerns. - If praised ask who else has concern and permission to help. - Approach visibly uncomfortable prospect by asking what is going on and permission to explain; greet stranger and offer help. Workflows: care-calendar-change, care-visit-loop, care-primary-booking Scripts: care-objection-phrase-bank Uncertainty: ['Source vaccination remark, blame, pain normalization and anti-medication binary must remain review-only archival text.'] Disposition: mapped ### IMG_0333 · Referrals, companion introduction and speaking opportunities Doctor identifies potential referrals and lecture hosts, and closes the name/number-to-call handoff. - Introduce self to accompanying friend, ask past chiropractic experience, then offer explanation/evaluation. - At social event ask what others do, reciprocally identify profession and ask experience. - When patient improves ask who else has same concern. - Ask enthusiastic patient for work/group/enrichment leader speaking contact. - Ask how patient explains office to others. - For direct referral ask name/number, request referring patient tell friend doctor will call in next day or two, walk to reception and explain concern/offer. Workflows: care-referral-capture, care-community-outreach Scripts: care-referral-capture Uncertainty: ['The printed blank lines are represented with underscores; their exact lengths are not significant or fully distinguishable.', 'Consent to sharing patient information and contacting the friend is not specified; proposal must add permission capture.'] Disposition: mapped ### IMG_0334 · Group orientation / doctor report outline Opening, whiteboard comparison and nine teaching steps precede private patient-film review. - Thank attendees, explain example films are not theirs, promise private review and affordability choice, ask phones/pagers off. - Draw top-to-bottom ranking line (#1 to worst); source calls for health-ranking statistics and top three US causes of death. - Source body instructs medical-system criticism, nervous-system posters, interference/subluxation explanation, medication analogy, historical pharmaceutical story, pre/post films, correction-time discussion and maintenance. - Source timeframe average three months to one year; Ending continues next page. Workflows: care-orientation-rof Scripts: care-orientation-report Uncertainty: ['Statistics/history/medical claims are historical unverified source; preserve for review. Do not activate the “destroy faith” instruction.'] Disposition: mapped ### IMG_0335 · Private ROF: commitment, barriers and enrollment handoff After closing story, first-arrived couple sees films privately with financial staff; commitment and barriers decide handoff. - Close group presentation with story and family-check invitation. - Take first-arrived couple privately with films ready and finance person present. - Ask what they see, meaning for cord/nerves, leaving it alone and commitment 1–10. - If below 10 ask why; cost and schedule barriers get conditional affordability/scheduling questions. - Source program example three times/week 90 days, then two then one as changes permit, total visits individualized. - At 10 hand to finance person for affordability, then adjustment. Workflows: care-orientation-rof, care-enrollment-barrier Scripts: care-private-rof Uncertainty: ['The lengths of the two printed fill-in lines are not fully clear; they are represented with underscores.', 'Clinical content and support-person authorization require review; commitment is voluntary and does not replace informed consent.'] Disposition: mapped ### IMG_0336 · Weekly billing meeting and auto/work-comp documentation Clinical documentation must be ready for insurance bills, with weekly physician-billing case review. - Handle billing requests during non-adjusting hours; set weekly meeting usually Tuesday. - Review travel cards to send insurers, initial/prognosis/final letters and case progress/next actions. - Every auto/work-comp bill requires completed chart notes; preferably record travel-card comments before patient leaves adjustment. Workflows: care-billing-review, care-visit-documentation Scripts: Uncertainty: [] Disposition: mapped ### IMG_0337 · Marketing daily checklist and weekly close Daily preparedness, reminder and missed-lead calling, event logistics, stats and signed next-week plan. - Check mailbox at start/end; post targets; book M/W/F 8–11 and 3–6 or Tuesday 3–6. - Use proper primary script and sufficient directions. - Event calendar must hold contact name/phone, full address, time, company; prepare pens, surveys, candy, tablecloths, massage boxes and cards. - Recall all scheduled appointments that missed. - Before leaving call next-day appointment reminders, organize desk/call-sheet stacks, record monthly stats and assess goals. - At week end write next-week talk/appointment/arrival goals and battle plan; sign and send to Division 7. Workflows: care-marketing-day, care-marketing-events, care-marketing-recall, care-marketing-reminder, care-marketing-stats Scripts: Uncertainty: ['The handwritten word on the sticky note is somewhat difficult to read; it appears to say “Marketing.”', 'Printed page 3 starts this captured marketing segment; photo order remains source anchor.'] Disposition: mapped ### IMG_0338 · Business gift-card partner letter and redemption call Partner gives clients a services/massage card, supplies name/phone and office calls if redemption does not occur. - Thank partner after meeting and explain gift-card arrangement. - Partner gift example includes services plus 30-minute massage for Diamond-package purchase; no cost to partner. - Obtain recipient name/phone so office can offer availability if not redeemed in reasonable time. - Redemption caller identifies partner and gift, offers morning/afternoon. Workflows: care-pgc-partner Scripts: care-pgc-partner-letter Uncertainty: ['“Reasonable time” undefined; benefit terms, partner claims and permission to contact need configuration.'] Disposition: mapped ### IMG_0339 · Marketing appointment close and directions Primary-script summary and three-step choice close, followed by directions and attendance commitment. - Find concern, explore life impact, explain possible help, make appointment. - Ask morning/afternoon, next two suitable blocks, then two times. - Give directions and ask whether any reason prevents attendance. - Historical location: enter Highland Drive south ramp and follow blue signs; avoid north/Creek Road entrance. Workflows: care-primary-booking Scripts: care-marketing-booking Uncertainty: ['Directions are site-specific historical content and must be replaced with verified current location at activation.'] Disposition: mapped ### IMG_0340 · Marketing priority order and weekly targets Twelve marketing channels ordered by priority with five explicit weekly activity targets. - Priority: referral calls, massage calls, stress-survey calls, business alliances, health fairs, PGC distribution/calls, social media, appreciation days, in-office health talks, charity, newsletters/email, website. - Appreciation days every two months; doctor in-office talk monthly. - Weekly source targets: 150+ lead calls, 80+ event calls, 10+ drop-ins with at least three on-spot schedules, 4–5 events, 80–100 leads. Workflows: care-marketing-hierarchy, care-marketing-events, care-marketing-stats, care-community-outreach Scripts: Uncertainty: ['“Patient Appreciation Days (Every 2 months” has no visible closing parenthesis; it is transcribed as shown.'] Disposition: mapped ### IMG_0341 · Marketing work blocks, output definition and quota graphs Defines finished product as qualified arrival completing Day 1, not a booking; tracks the next two weeks. - Source contact windows: HR 8–11 or 1–3:30, outdoor promotion 12–2, home calls 5–7:30; alternate routine values 6:30–8 and says 5–6 slow. - Possible schedule Monday–Thursday 9–7, Friday 8–2; alternative starts 10 and works to 7. - NPI means qualified new person with concern and offer interest who arrives and completes Day 1. - Track weekly 150+ leads calls, 80+ event calls, 10+ drop-ins with three schedules, 4–5 events, 80–100 leads. - Quota graphs: future events, completed events, calls, NPI booked this/next week, collected leads, PGC distributed/activated. - Review weekly future NPI shortfall; display four months of desk calendars. Workflows: care-marketing-hierarchy, care-marketing-stats, care-marketing-training, care-lead-qualification Scripts: Uncertainty: ['Calling-window alternatives conflict; select current approved office/contact windows, not automatic universal schedule.'] Disposition: mapped ### IMG_0342 · Set up marketing workspace and management cadence Training, forms, support calls and visible operating materials establish the department. - Display hierarchy, quota graph, daily handle sheet, 12 weeks of stats and Monday Marketing Form in addition to calendars. - Complete course; bi-weekly calls with Joshua; download Sub-products Spreadsheet from tool box. - Monday meeting uses Monday/Daily Marketing Forms. - Provide own computer/workspace, prepared materials and marketing phone/headset. Workflows: care-marketing-training, care-marketing-stats Scripts: Uncertainty: ['“Bi-weekly” can mean twice weekly or every two weeks; referenced toolbox/forms and Joshua relationship must be verified.'] Disposition: mapped ### IMG_0343 · Marketing qualification and employee competency signoff Historical qualified-lead criteria and measurable role-certification requirements. - Source qualified patient: local home/work, full-time job, age 23+, concern they want resolved. - Nonqualified may become qualified with parent or enrollment resolving financial barrier. - Learn model and primary script; obtain names/numbers across channels; follow hierarchy. - Post goals, tally daily calls and track appointments/events/NPI/alliances/surveys. - Trainer signs/dates understanding; successful script use with five arrived NPIs; sufficient lead generation; tracking ability; ten NPI/week and rising stats. - Record team member and hire date. Workflows: care-marketing-training, care-lead-qualification, care-marketing-stats Scripts: Uncertainty: ['Age/employment criteria are marketing segmentation in historical source, not clinical eligibility or automatic denial of care.'] Disposition: mapped ### IMG_0344 · Marketing training explanation and script benchmark Philosophy/claims reference and 70% conversation-to-evaluation aspiration support marketing training. - Learn source explanation of chiropractic and medical comparison, symptom analogy and nutrition/stress/exercise classes. - Use one-to-one or group teaching to lead to primary script and evaluation. - Collect local prospect names/numbers and call using primary script. - Source proposes 70% of conversations leading to no-cost evaluation as mastery benchmark. Workflows: care-marketing-training, care-primary-booking Scripts: care-marketing-explanation Uncertainty: ['The printed word is clearly spelled “sewed”; it is retained as printed, despite the possibility that the author intended “sued.”', 'Faint curved marks appear in the left margin and seem to be non-text marks.', 'Broad disease-cure, safest-treatment and anti-medical claims are unsupported source statements pending review; 70% is author benchmark, not forecast.'] Disposition: mapped ### IMG_0345 · Ten channels for referral and event leads Staff-generated contacts, family invitations, rehab conversations, donation meetings, talks, PGCs, appreciation, contests and charity. - Ask improving patients for friend name/number for free evaluation. - Invite new-patient family within first two weeks at practice expense; continue inviting later if missed. - Rehab specialist uses referral/group/organization/business lead paper during exercises. - Call HR to arrange five-minute doctor donation meeting using script. - Arrange speaking events at churches/schools/clubs/beauty schools; source references nonprofit membership/hours. - Staff distribute PGCs; appreciation day with theme/referral-prize entries; staff referral competition optional. - Partner with charity and allied businesses; example screening contribution is hygiene items. - All staff contribute leads; be creative. Workflows: care-referral-capture, care-family-check, care-community-outreach, care-marketing-events, care-marketing-hierarchy Scripts: care-donation-meeting Uncertainty: ['“Bi-monthly” ambiguous here but IMG_0340 explicitly says every two months. Nonprofit/donation statements must be true before use.'] Disposition: mapped ### IMG_0346 · Daily results and weekly goal improvement Track effort daily against weekly targets and get help when performance stalls. - Set goal, track for a week, aim to meet rising weekly goals. - If trying but not growing and cause unknown, ask someone who can help. - Record daily efforts on following stat sheet. Workflows: care-marketing-stats Scripts: Uncertainty: ['Following stat sheet is outside assigned photo range; cross-reference next part.'] Disposition: mapped ### IMG_0347 · Historical rationale: Wilk v. AMA Historical advocacy background describing the author’s account of opposition to chiropractic. No operational sequence is specified. Workflows: Scripts: Uncertainty: ['The page number at the far right is partly clipped by the photograph, but appears to read 12.', 'Historical quotations and legal characterizations are source claims, not independently verified by this analysis.'] Disposition: reference ### IMG_0348 · Training-hours comparison and Primary Script rationale A historical training-hours table and the author’s rationale for educating patients about corrective chiropractic. Leads into the Primary Script. - Train staff to use the Primary Script and educate themselves before educating patients. - Preserve the printed table and author viewpoint as historical reference, not a current credential comparison or a verified clinical claim. Workflows: grow-prospect-discovery Scripts: Uncertainty: [] Disposition: reference ### IMG_0349 · Primary Script: discovery, qualification and referral branch Complete prospect conversation: concerns, alternatives if no symptoms, detailed impact questions, explanatory analogy, no-cost evaluation close, and referral alternative. - Ask about concerning health problems; if no, ask about energy, weight or sleep changes. - With concerns, obtain permission, identify the most concerning issue and explore duration, prior attempts, results, severity, work, family and hobbies. - Ask permission before the chiropractic explanation; the source uses a rock-in-shoe nerve-pressure analogy and claims possible permanent relief. - Offer a no-cost evaluation and morning/afternoon choice. - If no concern or desired change, say they do not qualify, explain briefly and ask if they know someone to gift the evaluation to. - If a referral is offered, explore the other person’s symptoms and obtain name and number. - If no referral, thank them and end; do not beg or sweeten the offer. Workflows: grow-prospect-discovery, grow-internal-referrals Scripts: grow-primary Uncertainty: [] Disposition: mapped ### IMG_0350 · Stress-survey call and Day 1 reminder Survey lead call invokes the Primary Script; scheduled Day 1 receives a night-before reminder with live-answer and voicemail branches. - Identify office and stress-survey venue on the call; discuss symptoms and book through the Primary Script. - If no symptoms or desired health changes, thank them and end. - Call night before Day 1 or early enough for schedule changes. - Live answer: confirm time and ask whether directions are needed or anyone is accompanying them. - Voicemail: office, appointment time, offer directions, callback number and expected arrival time. Workflows: grow-survey-lead, grow-day1-reminder Scripts: Uncertainty: [] Disposition: mapped ### IMG_0351 · Public gift certificate handout and contact capture Two street/outreach versions activate a gift card with staff initials and capture first name/phone for follow-up, plus three objections. - Go where people are with public gift certificates (PGCs) and a 3 x 5 card or small pad. - Ask whether they live/work locally; offer the bodyworks/massage card. - If unwanted, say no problem and wish them a good day. - If accepted, take card back, add staff initials to identify its source and return it as activated. - Tell the recipient to call the printed number to book. - Capture first name and phone on the card/pad. - Tell them that if the office has not heard in a couple of days, staff will call with available times. - For reluctance to share number, explain it is for offering available times and ask permission. - Explain one-use limitation if asked about the catch; explain advertising through touch if asked why free. Workflows: grow-pgc-handout Scripts: grow-pgc-handout Uncertainty: [] Disposition: mapped ### IMG_0352 · PGC follow-up call and two-day expectations Gift-card call schedules a time, asks health concerns, uses Primary Script, explains doctor evaluation then findings/massage, and confirms directions. - Identify the offices, gift package and certificate giver. - Offer available morning/afternoon time and set appointment. - Ask health concerns because massage is therapeutic; use Primary Script. - Explain package spans two days: evaluation first, findings and massage setup second. - Invite questions, give directions and repeat date/time and named health concern. Workflows: grow-pgc-call Scripts: grow-pgc-call Uncertainty: ['The fill-in fields are printed as underline rules; the underscore counts used to represent them are approximate.'] Disposition: mapped ### IMG_0353 · Marketing production cadence Defines minimum screening, business meetings, lectures, advanced talks and alternating-month three-week promotion cadence. - Arrange one screening per month to collect names/numbers through stress surveys; call leads using survey call script. - Example fair uses candy and a massage raffle; some win massage and all receive offered evaluation. - Every other month schedule three events: patient/guest dinner, in-office lecture and patient appreciation day (PAD). - Arrange four outside business meetings per week using patient employer/club/church contacts, errands, business calls or cold calls. - Schedule two outside lectures/meetings per week; accept small groups even three employees. - Schedule one inside advanced talk monthly; in promo months use the second event. - Announce the next talk a month beforehand at the prior talk and keep a sign-up sheet at reception. - Talk structure: welcome/introduction, information, tie-in to nervous-system rationale, gift of no-charge evaluations for attendees/family. - Prefer evaluations following the talk, otherwise schedule later. Workflows: grow-survey-lead, grow-screening, grow-business-outreach, grow-advanced-talk, grow-three-week-promo, grow-recurring-marketing-calendar Scripts: Uncertainty: [] Disposition: mapped ### IMG_0354 · Marketing director training and business-event intake Role training seeks 20–25 new patients per office per week through business outreach, events, scripts and internal marketing operations. - Goal is 20–25 new patients per week at each office; this is a source target, not a forecast. - Learn to reach HR/safety contact, explain donated no-cost doctor services, and book a meeting with doctor. - Memorize and perform Primary Script. - Set up events to obtain names/numbers and stop, educate and book prospective patients. - Orchestrate PAD, community appreciation, three-week promos, newsletters, handouts, whiteboards, monthly themes, decorations, press releases, newspaper ads, testimonials and email/fax marketing. - Run five-minute business needs meetings: select lecture, lunch-and-learn, ergonomics, employee screening, fair or consultation. - Capture event time, location, topic, allowed time, attendee count and service being offered. - Learn to deliver nutrition, exercise, stress/time-management and stress-survey/brain-body talks to expand doctor capacity. Workflows: grow-screening, grow-business-outreach, grow-advanced-talk, grow-internal-education Scripts: Uncertainty: [] Disposition: mapped ### IMG_0355 · Professional networking and health-fair development Relationship-building with complementary professionals and employer safety contacts, including referrals, trial cases and source-specific appreciation rules. - Develop reciprocal working relationships with physicians, attorneys, spas, trainers, health stores, martial arts businesses and other appropriate partners. - Seek introductions from satisfied patients; doctor explains scope differences and referral fit to prospective partner. - Offer to review cases the partner is unsure of. - Before any relationship reward/wining and dining, speak to Dr. Thomas as explicitly directed. - Find fairs through businesses, churches/cities and patient employer contacts; reach safety person. - Offer screenings, injury evaluation and workplace injury-prevention education as no-cost community service. - If asked why free, explain allocated community service and becoming a familiar trusted resource; retain original rhetoric only as historical script pending review. Workflows: grow-screening, grow-business-outreach, grow-partner-network Scripts: Uncertainty: [] Disposition: mapped ### IMG_0356 · Have a Heart referral-and-business lead form Two identical copies of the form collect the patient’s own contact, friends/family and employer/group/church contacts. - Capture patient name and best phone. - Capture friends/family the patient wants checked. - Capture company and safety/HR contact. - Capture club/group and contact person. - Capture church and contact person. Workflows: grow-pgc-handout, grow-internal-referrals, grow-lead-raffle Scripts: Uncertainty: ['Faint text shows through the paper, but no words can be read confidently; it is marked [illegible] and not reconstructed.', 'No printed page number is visible.', 'Foreground form is printed twice on this same sheet; not two distinct workflows.'] Disposition: mapped ### IMG_0357 · In-office event preparation and room setup Advance planning, staff education, attendance expectations, visual promotions and minute-specific event setup. - Schedule talks/events at least one month in advance. - From at least two weeks before event through event day, prepare staff, décor, whiteboards, posters and handouts. - Hold new-patient orientation every two weeks; schedule every patient who has not attended; book calls this part of treatment. - Book requires patients to attend two special-topic talks per year. - All staff must know what/when/who/why and help sign up intended attendees. - Talks normally Tuesday or Wednesday 6:15 p.m.; arrange adjustments before 6 p.m. - At 6 p.m. support staff move tables 2/3, retain table 1, orient chairs toward whiteboard, prepare handouts/easel/flip chart and clean board with marker/eraser. - Move remaining adjustment patients to exam rooms so talk starts at 6:15. - After talk collect names/3 x 5 cards for evaluations or business/HR follow-up. Workflows: grow-advanced-talk, grow-event-setup Scripts: Uncertainty: ['The six repeated upper-list markers are visibly euro-shaped and are transcribed literally as €.'] Disposition: mapped ### IMG_0358 · Enrollment work priority hierarchy Explicit ordering of enrollment work and doctor escalation when lesser duties exceed capacity. - Highest priority: be in patient room for Day 1, Day 2, Day 3, re-signs or Room 4. - Second: prepare for those appointments. - Third: set up new Day 1/2/3/re-sign appointments. - All other duties are secondary. - If priority work fully occupies enrollment and other duties are uncompleted, notify Dr. Thomas to arrange coverage. Workflows: grow-enrollment-priority Scripts: Uncertainty: [] Disposition: mapped ### IMG_0359 · Financial arrangement: cost disclosure and options After ROF, at plan end or in Room 4, sit beside patient and explain clinician recommendations and successive financing options. - Perform financial arrangement after ROF, when creating next plan, or during Room 4. - Sit beside patient with paperwork, not across paperwork barrier. - Show Corrective Care Plan and reasoning for visit total before discussing any payment option. - Show total and first offer source one-time 20% bookkeeping discount with dollar savings. - If moving to monthly, cross out one-time option; ask down payment and spread remaining balance over six months initially without discount. - If needed, extend months to lower payment; source allows card on file or postdated checks. - If options unaffordable, ask about finances to distinguish disclosed affordability constraints from hesitation; continuation is on next photo. Workflows: grow-financial Scripts: grow-finance Uncertainty: ['The visible text ends abruptly after “out” without punctuation or following text; the word itself is fully visible.', 'Source presumes nondisclosure means lack of belief rather than affordability; do not encode this as a factual patient classification.'] Disposition: mapped ### IMG_0360 · Modified plan, three-visit trial and financial escalation Continuation supplies annual-budget formula, source fee examples, exercise changes, trial path and doctor escalation. - If relief-only or not ready for full plan, offer three visits at regular per-visit fee then revisit longer plan only if patient wants. - Modified plan asks down payment and affordable monthly sum; annual budget = down payment + 12×monthly. - Source example: $200 + 12×$100 = $1,400; $55/visit yields 25 adjustments. - Source modified terms: no-cost exams and rehab, $30 per x-ray; clinical source changes home exercise from 15 to 30 minutes morning and evening. - Acknowledge desire to think; ask what is holding patient back and discuss questions with decision makers present. - If patient shares finances, consider modified plan; if not, source offers three-visit trial. - If nothing resolves, retrieve doctor using “let me see if Dr. Thomas has any other questions.” - Always show recommended care and financial pages first, then four options; do not begin payment negotiation without full cost. Workflows: grow-financial Scripts: grow-finance-modified Uncertainty: ['The visible text begins with the lowercase fragment “first,”; the preceding context is not shown.'] Disposition: mapped ### IMG_0361 · Day 1, Day 2, Day 3 confirmation and missed-visit branches Separate scripts and recovery intent for early stages, with spouse participation and in-person financial handling. - Confirm Day 1 time via directions question. - If forgotten/canceling Day 1, use Primary Script; also use on missed Day 1 whether or not they reschedule. - Confirm Day 2 doctor findings appointment with named spouse; ask early arrival and written questions. - Reschedule Day 2 if spouse cannot attend, per source. - On skipped Day 2 use source doctor-concern/x-ray prompt to reschedule; clinical claim must be true and clinician-confirmed. - Day 3 usually has no confirmation call; use judgment. - On missed Day 3 discover cause, rebuild commitment and resolve promptly; source prefers financial discussion in person. Workflows: grow-day1-reminder, grow-day1-missed, grow-day2-followthrough, grow-day3-missed Scripts: grow-early-stage-calls Uncertainty: ['The blank name fields are printed underline blanks; they are represented as _____ in the transcription.'] Disposition: mapped ### IMG_0362 · Telephone coverage, messages and new-patient booking All-team call standards and full new-patient booking sequence including family scope, attribution, injury paperwork and insurance benefits check. - All team members learn scripts, smile while answering and answer by third ring. - Receptionist coordinates human phone coverage Monday–Friday 8–5. - Message record includes from, to, date, details and staff initials. - Ask caller identity/reason to decide whether to interrupt; emergency means hold and get recipient. - Collect all phone numbers when patient arrives. - Source says do not quote new-patient prices by telephone; answer questions then offer morning/afternoon booking. - Determine returning versus new patient by last visit. - Ask appointment for self or entire family, name and phone; offer next two day/time slots. - Capture how heard and named referrer, arrange thanks on referrer’s next visit. - Give directions from point of departure. - Ask auto accident or work injury and prepare extra forms if applicable. - Ask to bring insurance for complimentary benefits check; close warmly. Workflows: grow-phone-coverage, grow-new-patient-booking Scripts: grow-phone-message, grow-new-patient-phone Uncertainty: ['The curved marks in the left margin appear to be stray marks, not text. No text appears illegible or cropped.'] Disposition: mapped ### IMG_0363 · Twenty-minute no-show rescue and appointment branches Immediate missed-appointment response, end-of-shift voicemail, possible release exam and ordinary rescheduling. - Call within 20 minutes of missed appointment. - If en route, obtain ETA and communicate arrival. - If not coming, address considerations and try same day or next day. - Corrective-care missed visit needs make-up day (MUD), handled at next appointment. - Source urges attendance if sick/hurting; modern clinical triage must determine appropriateness. - For cost/scheduling/feeling better/worse concerns, address issue, seek one appointment and notify someone for Room 4 on arrival. - If unreachable, leave end-of-shift message assigning 5:30 that night; proposed implementation must mark tentative until patient accepts. - If feels better and refuses, offer possible release exam. - Returning booking: ask last visit and offer two next slots. - Recent missed appointment without suspected issue: check all right and reschedule. Workflows: grow-regular-missed Scripts: grow-missed-care Uncertainty: ['The text is legible. The precise lengths of the printed fill-in lines are not significant to the wording and are represented with underscore placeholders.'] Disposition: mapped ### IMG_0364 · Repeated absence, long-inactive recovery and survey lead calls Discover and resolve reasons for repeated absences; doctor escalation if patient refuses; long-inactive branches and survey script. - Document all communications; resolve discovered problem or arrange visit to solve it. - Several consecutive missed visits: ask what happened; if no reschedule tell doctor. - Long absence: doctor-requested welfare call and review prior symptoms. - If well and helped, offer maintenance check; if declined ask permission for future follow-up and ask about referrals. - If not helped or office upset, attempt repair and arrange return. - If not well, explore what is happening and arrange doctor evaluation. - Stress survey: name event and recorded symptoms, prioritize main concern and use Primary Script. - If no symptoms or desired health changes, thank and end. Workflows: grow-survey-lead, grow-regular-missed, grow-inactive-checkin Scripts: grow-survey-call, grow-repeated-missed, grow-inactive-call Uncertainty: ['The exact lengths of the printed blank lines are difficult to distinguish; underscores are approximate.'] Disposition: mapped ### IMG_0365 · Repeated absence and survey call duplicate Second photograph of the same substantive repeated-absence, long-inactive and survey-call page. - Same operational requirements as IMG_0364; do not create duplicate patient tasks or duplicate sequence sends. Workflows: grow-survey-lead, grow-regular-missed, grow-inactive-checkin Scripts: Uncertainty: ['The exact lengths of the printed fill-in underline blanks are difficult to distinguish; they are represented with underscores.', 'Recaptured duplicate/near-duplicate of IMG_0364; source spelling/layout differences remain visible. Merge operational execution with canonical source rather than schedule a second workflow.'] Disposition: duplicate ### IMG_0366 · Primary Script variant and repeated price inquiry Alternate primary script uses “help” wording and adds three progressively specific fee-question responses plus enrollment handoff. - Use alternate Primary Script to discover health concerns and offer evaluation. - Source directs getting patient to “ruin”; retain historical intent separately from approved respectful language. - First price question: no-cost doctor meeting and morning/afternoon choice. - Repeated price question: costs vary, consultation free, doctor discusses fees before doing anything. - Further price question: ask usual payment; source says “We can work with that.” - Pass price expectation to enrollment on arrival; doctor decides actual fees. Workflows: grow-prospect-discovery, grow-new-patient-booking Scripts: grow-primary-alt, grow-price-inquiry Uncertainty: ['The image appears to print a closing quotation mark after “Sample questions are” without a visible opening quotation mark; this has been transcribed as shown.', 'The printed wording “the can’t” and “ruin” is unusual, but those words are visible in the image and have been retained.'] Disposition: mapped ### IMG_0367 · New-patient reminder, PGC variant and no-show diagnosis Reminder and certificate scripts with a 30-minute massage variant; a troubleshooting table suggests reasons for different missed stages. - Call night before or early enough for schedule changes; live/voicemail both offer directions. - PGC variant describes complimentary bodyworks and 30-minute massage, asks concerns before scheduling, and explains evaluation then findings and massage. - Missed Day 1: source recommends repeating Primary Script. - Missed Day 2: source recommends prompt findings reschedule. - Missed Day 3: explore finances, commitment and absent spouse; facilitate patient decision. - Missed regular visit: discover actual cause including improvement, worsening, move, doctor dissatisfaction or bereavement; resolve if possible. Workflows: grow-pgc-call, grow-day1-reminder, grow-day1-missed, grow-day2-followthrough, grow-day3-missed Scripts: grow-pgc-call-30, grow-day1-reminder Uncertainty: ['The initial C in “Call” is partly obscured by a mark at the left edge, but the word is readable.', 'Troubleshooting causes are author hypotheses, not confirmed causes to assign automatically.'] Disposition: mapped ### IMG_0368 · Unresolved recovery handoff and exit routing Closes missed-appointment recovery with quality-control review and an exit-form route for permanent status changes. - If patient cannot be brought back/problem solved, record notes and give to quality control for decision. - If moved, died or equivalent exit reason, initiate EXIT FORM routing. Workflows: grow-qc-exit Scripts: Uncertainty: ['Faint reverse-side text showing through the page is not sufficiently legible to transcribe.'] Disposition: mapped ### IMG_0369 · Low new-patient volume recovery and inactive return intake Daily missed-first-visit recovery pool plus other lead sources, and special check-in for patients returning after a month or more. - When Day 1 volume is insufficient, daily record red-book missed Day 1 names/numbers in computer for Reception/Marketing/Enrollment recovery using Primary Script. - Also call missed Day 2/3, survey leads, PGCs, patient referrals and massage patients. - Ask active patients for referrals, HR contacts and club/church lecture opportunities. - Distribute PGCs/stress surveys and book appointments. - For inactive return, usually one month or longer, recommit and check new accident/injury. - If long absence, update all paperwork and perform new-patient-style consultation. - Reception has patient sit, withholds travel card from patient and gives it to CA. - Pull prior films from office/storage (source says films kept seven years) and take patient to consultation room. Workflows: grow-day1-missed, grow-low-volume, grow-inactive-return Scripts: grow-business-intro Uncertainty: ['A neighboring sheet is partially visible at the right edge of the image, with text cropped; it is not included as part of this page’s transcription.'] Disposition: mapped ### IMG_0370 · Inactive-return consultation and doctor handoff Continuation handles new injury, barriers and care restart; doctor handoff is explicit when CA cannot resolve. - Ask whether any injury since last visit. - Handle education, calendar, finances and other barriers. - Once handled, prepare patient for adjustment in Room 4. - If beyond CA ability or doctor should handle, tell patient doctor will be right with them. - Get doctor’s attention outside cracked door with folder, brief doctor, accompany doctor, observe and record instructions. Workflows: grow-inactive-return Scripts: Uncertainty: ['“There last appointment” is clearly printed that way; it may be an author’s error, so it is retained verbatim.'] Disposition: mapped ### IMG_0371 · Room 4 and testimonial discovery Private-room issue resolution with CA ownership and a four-question testimonial interview when patient reports improvement. - Use consultation room or x-ray room if occupied for extended calendar/financial/no-show/dropout issues or testimonials. - CA resolves as many matters as possible; involve doctor only as necessary. - Prepare background, route travel card to CA, privately escort patient and address issues with concern. - When patient reports positive change, obtain written or video testimonial. - Ask life before care, prior attempts, prior results and change attributed by patient to care. - Ask permission to share/wall display and write exact comments. Workflows: grow-testimonial, grow-room4 Scripts: grow-testimonial-interview Uncertainty: ['Text from an adjacent page is visible at the far right but cropped. The visible fragments appear to read “Patien,” “Week,” “Week,” and “Video”; their remaining text cannot be confirmed.'] Disposition: mapped ### IMG_0372 · Testimonial authorization, display and education distribution Testimonial publishing completion, monthly recognition imagery and regular patient-education handouts/videos. - Type patient story; patient reads and approves, then signs authorization. - File authorization with other forms at CA 1. - Take patient photograph; display picture and approved story on wall. - Photograph patient of month with award chair/gifts; source selection based on referrals. - Hand out new testimonials every Monday and Thursday. - Distribute weekly health/well-being articles. - Record testimonials and show with other office videos on room TVs. Workflows: grow-internal-education, grow-testimonial, grow-patient-month Scripts: Uncertainty: [] Disposition: mapped ### IMG_0373 · Internal growth triggers and recurring marketing calendar Education/referral trigger moments and a calendar of recurring outreach activities. - Put new handouts on all seats and change whiteboard every Monday/Wednesday/Friday. - Use testimonials, patient of month, re-exams/referrals and Primary Script with patients. - Every other month schedule dinner, talk and PAD. - Collect referral names after doctor report while awaiting films, after re-exams, on enthusiasm about progress and during post-report financial session. - During financial session schedule family within next two weeks. - Call businesses weekly for HR/safety, source describes nonprofit speakers bureau. - First Monday of month: three-card Monday. - Third Wednesday: kids, family or charity day. - Weekly outside event, monthly screening and monthly in-office advanced talk. - Annual calendar includes 8–12 PADs, with remaining annual list continued on next page. Workflows: grow-business-outreach, grow-advanced-talk, grow-internal-education, grow-internal-referrals, grow-three-week-promo, grow-recurring-marketing-calendar Scripts: Uncertainty: [] Disposition: mapped ### IMG_0374 · Annual marketing calendar continuation Annual advanced talks, dinners, coupons and referral-lead raffle cadence. - Schedule 8–12 advanced talks/year one week before PAD; maintain signup sheets for next three topics (nutrition/stress/exercise). - Dinner occurs one week before advanced talk; appreciation, food, brief testimonials, doctor story, free family check in next two days. - Referral coupons source example: $35 exam/x-rays. - Lead raffle quarterly or every six months, may overlap PAD; gather business/event/talk contacts. Workflows: grow-advanced-talk, grow-three-week-promo, grow-recurring-marketing-calendar, grow-lead-raffle Scripts: Uncertainty: [] Disposition: mapped ### IMG_0375 · Three-week promotion: dinner, workshop, PAD Detailed dinner recruiting and event agenda, two-week lead follow-up, workshop topics and promotional offers. - Review referenced teleconference guidance; it is not included in these photos. - Choose pool about 30 patients; invite 10 plus guests two weeks ahead; ask confirmation in 2–3 days and replace declines until 10 confirmed. - Guests may be spouses/friends and may already be patients; purpose is thanks/inspiration. - Dinner agenda: appreciation, 1–2-minute introductions/referrer/progress stories, food, doctor story/mission, next two events, contact cards and thanks. - Source dinner example offers 20 referral slots at $17 charity donation for exam/x-rays/first adjustment; guests book tomorrow/Friday before leaving. - Collect contacts for groups/clubs/churches and health/stress/exercise/nutrition/work-injury talks. - After dinner obtain good testimonials in writing and follow up contact-card names over next two weeks. - Advanced workshop topics include stress, nutrition, exercise, time management. - PAD source examples include trail mix, Day 1/2/3 for $12 donation or free beach day. - Communicate opportunity, real capacity limits and enthusiasm; continuation adds time limit and thanks. Workflows: grow-three-week-promo, grow-testimonial Scripts: grow-dinner-offer Uncertainty: [] Disposition: mapped ### IMG_0376 · PAD time limit and participation recognition Continuation of PAD promotion checklist. - Communicate limited event time. - Thank participants; source sample prize is $50 mall gift certificate for first place and $5 for others. Workflows: grow-three-week-promo Scripts: Uncertainty: [] Disposition: mapped ### IMG_0377 · Outside events, screenings and complete lead follow-up External talk acquisition, monthly fair representation and follow-up responsibility. - Obtain outside-talk/office-workshop opportunities through in-office lead contests and patient referrals at reports, re-exams and workshops. - PRCA and/or doctor attends screenings in public venues using stress survey and Primary Script. - Aim for representation at at least one health fair per month. - Offer company talks/lunch-and-learns on health, nutrition, exercise, stress and productivity as community education. - Follow up all leads. - Organize all contacts. Workflows: grow-screening, grow-business-outreach, grow-recurring-marketing-calendar Scripts: Uncertainty: ['Some initial letters along the left side are faint, but the words are readable from the visible letterforms.', 'Claim that all >50-employee companies have a yearly fair is a source generalization, not an eligibility rule.'] Disposition: mapped ### IMG_0378 · Physician referral outreach and unscheduled-opportunity control Close all outside-event scheduling loops; physician outreach uses handwritten introduction, doctor phone follow-up and monthly articles. - Do not leave a potential new patient, fair or talk without scheduling follow-through. - Compile physician names/addresses for GPs, orthopedists, neurologists and OB/GYNs. - Send short handwritten doctor introduction asking for a reciprocal referral contact. - Several days later doctor calls each nonresponder and reiterates letter. - Send article with handwritten sticky note monthly. - Source limits physician mail to at most once/month and forbids gifts; thank-you note is sufficient. - In-office raffle begins here and continues next photo. Workflows: grow-screening, grow-business-outreach, grow-physician-outreach Scripts: grow-physician-letter Uncertainty: ['The Step 1 example appears to open a quotation, but no clearly visible closing quotation mark precedes the final parenthesis; none has been added.'] Disposition: mapped ### IMG_0379 · Referral raffle and Patient of the Month Raffle ticket rules and complete monthly recognition workflow with authorization prerequisite. - At PAD or periodic event, give one raffle ticket per patient referral and two per business/church/group-talk referral. - Office manager selects patient of month based on referrals, engagement, kept appointments and results. - Ensure typed testimonial and signed permission on file. - Display photo/story on poster/easel prominently. - Present gift visibly, photograph presentation and repeat monthly. Workflows: grow-lead-raffle, grow-testimonial, grow-patient-month Scripts: Uncertainty: [] Disposition: mapped ### IMG_0380 · New Year reactivation campaign and opening call Inactive-patient review, daily mailing limit, personal touches, fixed call delay and clinical return branches. - Print/order Yearly Healthy reactivation invitations (referenced Agenda 2 p 13). - CA and doctor review patients inactive 6 months–2 years; exclude doctor-selected names into source “dead file.” - Track mailing; send only 10 envelopes/day. - Include personal note and office signatures; CA records personal tidbits in computer. - Call five days after mailing using reactivation script. - Returning patient completes Update Form (Agenda 2 p 14). - Minor problems: same-day report with prior films if available. - New problem: new films only if normally indicated and report following day. - Doctor consultation/checkup and source adrenal check; offer plan of 12 visits or fewer counting free visit, source prepaid discount 15%. - Call verifies invitation, explains free adjustment/checkup, then continues symptom review next page. Workflows: grow-new-year-reactivation Scripts: grow-reactivation-newyear Uncertainty: [] Disposition: mapped ### IMG_0381 · Reactivation call branches and Valentine invitation Completes New Year symptoms/objection call and starts Valentine letter offering two-week gift. - Review original and secondary complaints, ask new issues; if present collect duration/frequency. - Offer a day choice for return evaluation. - If not interested, ask whether office upset; address and retry booking when applicable. - If merely uninterested/busy/well and no issue, thank and end. - Valentine letter offers free adjustment/stress evaluation for next two weeks and explains claimed stress benefits. Workflows: grow-new-year-reactivation, grow-valentine-reactivation Scripts: grow-reactivation-newyear, grow-valentine-letter Uncertainty: ['Letter claim that stress contributes to >80% of disease is unverified historical marketing language.'] Disposition: mapped ### IMG_0382 · Valentine letter completion and mailing workflow Letter offers staff follow-up, phone record update and family gift; campaign repeats inactive review with two certificates per envelope. - Letter promises follow-up call if no response and permits phone record update if patient declines gift. - Include family/friend gift certificate for consultation/stress analysis. - Print Valentine invitation; review inactive 6-month–2-year list with doctor and exclude unwanted reactivation names. - Track sends; mail 10 envelopes/day with two certificates. - Personalize and have staff sign; record personal details. - Preserve bracketed adrenal/stress assertions as source reference requiring clinician review, not automated diagnosis. Workflows: grow-valentine-reactivation Scripts: grow-valentine-letter Uncertainty: ['Step 4 names Start the Year Healthy invitation inside Valentine campaign; likely copied label but source retained for decision.'] Disposition: mapped ### IMG_0383 · Valentine reactivation return plan and call Five-day follow-up and return-visit branches repeat New Year process; full phone introduction and symptoms review continue. - Call five days after mailing. - On return obtain Update Form. - Minor problems: report same day, prior films if available. - New problem: clinician considers imaging and report next day. - Doctor checkup/adrenal check in source; plan no more than 12 visits including free visit; 15% prepay example. - Call explains offer, reviews previous complaints and asks new issues/duration/frequency. Workflows: grow-valentine-reactivation Scripts: grow-reactivation-valentine Uncertainty: ['The printed word appears to be “Yu” (rather than “You”) in “Yu also had a problem with”; this apparent typo has been retained.', 'Item 10 visibly reads “and so a report the next day.” The wording is unusual, but “so” is what appears in the image.'] Disposition: mapped ### IMG_0384 · Reactivation refusal, lost-certificate and upset branches End of Valentine call includes lost-certificate reassurance and explicit graceful ending on refusal. - Offer day choices if symptoms; lost certificate does not block booking. - If not interested, ask about office upset. - If upset, handle and attempt scheduling again. - If no upset and declines for time/no need/feeling well, thank and end. Workflows: grow-valentine-reactivation Scripts: grow-reactivation-valentine Uncertainty: [] Disposition: mapped ### IMG_0385 · Have a Heart charity campaign setup and invitation Valentine charity referral campaign with signed letters, roses, mailing and five-day calls. - Choose local charity, source example women’s shelter. - Print flyer and distribute two weeks before Valentine’s Day. - Prepare Valentine card letter for patient signature and gift certificates. - Arrange roses; source supplier/price historical. - Give adult patients flower day before Valentine’s; ask to read flyer and explain. - For donation source range $5–$20 offer gift certificate for consultation/stress check/massage to recipient. - Participation explicitly optional/no pressure. - Capture recipient name/phone/address; patient signs letter; office handwrites envelope, stamps and mails. - Call generated lead five days later. - Prepare donation press release. Workflows: grow-charity-campaign Scripts: grow-charity-invite Uncertainty: ['The first character of the final speaker label is obscured; the remaining visible text reads “T: $10,” and the label may be “PT:”.'] Disposition: mapped ### IMG_0386 · Charity recipient nomination and follow-up call opening Complete nomination conversation and begin courtesy gift-explanation call. - Ask who patient wants to receive gift. - If no name, source prompts symptoms such as arthritis/headache/back/neck/digestion/hormonal problems. - Ask details and obtain mailing address. - Ask phone to answer recipient questions. - Have patient sign letter and add personal comments. - Call recipient by name, identify doctor office and named giver, explain consultation/screening and brief trigger-point massage. Workflows: grow-charity-campaign Scripts: grow-charity-invite, grow-charity-call Uncertainty: ['The opening bracket before “Have” is partly obscured by the binder, but appears to be present.'] Disposition: mapped ### IMG_0387 · Charity follow-up offer, duration and family extension Completes charity call with source value comparison, 45-minute booking choice and family invitation. - Explain consultation/screening offer and source claim of natural solutions; review claims before approved use. - Source compares other-doctor value $150–$300 with no charge; historical amount requires verification. - State 45-minute appointment and ask morning/afternoon/evening. - If booking only self, extend opportunity to other family member. Workflows: grow-charity-campaign Scripts: grow-charity-call Uncertainty: [] Disposition: mapped ### IMG_0388 · Family Day materials, referral delivery and conversation Family history/flyer collection with co-resident hand delivery versus mailing and five-day follow-up. - Display Family Day poster; staff wear Ask me about Family Day tag. - Prepare flyer and referral letter/family health history forms. - Ask patient how they feel; if well give flyer/clipboard/history form to complete. - Review form and ask which relatives are local and who should be evaluated. - For co-resident relatives give material to patient instead of mailing. - Otherwise collect address; office handwrites/stamps/mails referral. - Capture family phone numbers and call five days later. Workflows: grow-family-day Scripts: grow-family-invite Uncertainty: [] Disposition: mapped ### IMG_0389 · Family Day tentative booking and follow-up script Capacity example, referral delivery choice and complete 45-minute invitation call. - Offer tentative family appointment; source example claims 15 openings, which must reflect actual availability in a modern system. - Fill referral envelope for office mailing or patient personal delivery. - Obtain recipient phone to give directions. - Follow-up names referring person and Family Health Week, explains consultation/screening/massage, no-charge offer and 45-minute duration. - Ask morning/afternoon/evening choice. Workflows: grow-family-day Scripts: grow-family-invite, grow-family-call Uncertainty: ['The adjacent sheet is cut off at the right edge; only the shown beginnings of its text and the numbers 1–4 are visible.', 'The phrase “about out Family Health Week” appears that way in the image; it has been retained as printed.', 'A hand-drawn curved bracket is visible beside the final appointment statement; no handwritten words are legible.'] Disposition: mapped ### IMG_0390 · Family extension, post-enrollment referrals and seventh-visit interview Complete Family Day family extension, immediate post-finance referral moment and visit-seven progress/retention/referral interview. - After own booking ask whether another family member would like opportunity. - Ask referrals after financial arrangement, offering family/friend evaluations and two certificates to distribute. - On visit seven CA 3 privately interviews patient and reviews original complaints and perceived improvement. - Record complaint scores across full visit-note line; source examples HA 5/NK 9/LB 2 represent remaining severity with 50%/10%/80% improvement. - Communicate outcome feedback to doctors. - Identify insufficient relief, new issues, doubts after feeling better and financial/insurance/education barriers; fix them promptly. - After evaluation request testimonial on recording and referrals including workplace/group/community-service talk contacts. - Give contact info to doctor; praise attendance and sharing story. Workflows: grow-internal-referrals, grow-testimonial, grow-family-day, grow-visit7 Scripts: grow-referral-post-finance, grow-family-call, grow-visit7-referral Uncertainty: [] Disposition: mapped ### IMG_0391 · Imaging preparation, markings and follow-up comparison Detailed x-ray processing queue, projection-specific marks and comparison preparation before follow-up report. - Place new films in NEW PATIENTS–TO BE MARKED queue; mark during day and especially before departure. - AP cervical: atlas and dominant listings; lateral cervical: atlas angle/proper curve. - AP thoracic: wedging, scoliosis/Cobb angle, listings. - AP lumbar: sacral base vs femur head, femur head vs film, sacral rotation/S 2 comparisons, wedging and listings. - Lateral lumbar: base angle, spondy/retro; record necessary additional marks, anomalies/pathology/fractures. - Complete Doctor Use Form. - Second films usually visit 24 or 36 (2–3 months), selected views for measurement, placed in original folder. - Mark comparative films carefully; if uncertain/no visible change, consult doctor before patient appointment. Workflows: grow-imaging-prep, grow-rereport Scripts: Uncertainty: ['Recaptured duplicate/near-duplicate of IMG_0312; source spelling/layout differences remain visible. Merge operational execution with canonical source rather than schedule a second workflow.'] Disposition: duplicate ### IMG_0392 · Day 1 consultation and doctor handoff Full first-day consultation script and outline; captures initial beliefs and top-two concerns for later report. - Introduce CA and escort patient to exam room. - Ask prior positive/negative beliefs about chiropractic and clarify misunderstandings. - Expand Primary Script into specific concerns/impact/fears and top-two priorities. - Write patient’s words for Day 2. - Explain what doctor will examine using posters/model and source nerve-pressure narrative. - Source says doctor will refer elsewhere if unable to help. - Get doctor by cracking door for exam; next page continues. Workflows: grow-day1 Scripts: grow-day1-consult Uncertainty: ['The outline’s item 4 has an opening quotation mark but no visible closing quotation mark; it is retained as printed.', 'The exact number of terminal dots after the “How old…” question is difficult to distinguish; the transcription represents the visible run as eight dots.', 'Source “ruin” instruction and deterministic organ-death claims require review; do not automate coercive or unsupported clinical language.', 'Recaptured duplicate/near-duplicate of IMG_0271; source spelling/layout differences remain visible. Merge operational execution with canonical source rather than schedule a second workflow.'] Disposition: duplicate ### IMG_0393 · Day 1 examination, ROF scheduling and fees Doctor handoff, exam record, imaging, significant-other ROF booking and fee collection. - Show doctor red travel-card concern list with ranked top 1/top 2. - Doctor explains exam findings, planned film review, costs and importance of significant other attending ROF. - Record exam findings, ordered films, charge and significant other name. - Take appropriate clinician-ordered films. - Book first available ROF and ask if any obstacle; call significant other or reschedule as needed under source. - Explain ROF covers findings, care plan, finances, home care; plan about an hour, source recommends babysitter. - Invite questions. - State itemized fees and total, then no-charge offer if applicable; example exam 30/films 120/total 150. - Accept cash/check/card. - Source outcome is strong desire to return Day 2. Workflows: grow-day1 Scripts: grow-day1-doctor, grow-rof-invitation, grow-day1-fees Uncertainty: ['Recaptured duplicate/near-duplicate of IMG_0272; source spelling/layout differences remain visible. Merge operational execution with canonical source rather than schedule a second workflow.'] Disposition: duplicate ### IMG_0394 · Day 2 file readiness and commitment conversation ROF preparation gate and graduated-commitment fallback before finance. - Verify insurance; pull/mark films; complete Doctor Use Form, corrective-care and financial forms. - Place file in ROF scheduled or not-scheduled bin; films ready in room on ROF date. - Review consequences and desire to address condition. - Explain punctuality, missed visits made up within seven days, home rehab and required health class plus further topics. - Ask commitment 1–10 and barriers; source seeks enthusiastic 10. - If cannot commit to full course, offer by-stages through first re-exam and monitoring progress. - Always ask obstacles to starting/staying through completion even after enthusiastic answer. Workflows: grow-day2, grow-regular-missed Scripts: grow-day2-commitment Uncertainty: ['Recaptured duplicate/near-duplicate of IMG_0273; source spelling/layout differences remain visible. Merge operational execution with canonical source rather than schedule a second workflow.'] Disposition: duplicate ### IMG_0395 · Day 2 obstacle close and private-issue preparation Completes obstacle loop and ready-to-start question; contains Room 4 preparation duplicated in later dedicated page. - Continue asking other obstacles and resolve them; ask ready to get started, then finances. - If time, audit financials, recommended vs actual adherence, films, notes and travel card before private meeting. - If no preparation time, inspect card/financial/payment/calendar and known facts briefly. - Ask patient about actual barriers; address all concerns. - If unable to solve, obtain information and set a follow-up meeting. Workflows: grow-room4, grow-day2 Scripts: grow-day2-commitment Uncertainty: ['Room 4 checklist is repeated on IMG_0397; linked to one workflow to prevent duplicate task creation.', 'Recaptured duplicate/near-duplicate of IMG_0274; source spelling/layout differences remain visible. Merge operational execution with canonical source rather than schedule a second workflow.'] Disposition: duplicate ### IMG_0396 · Day 3 completion gate End-of-enrollment checklist requires finance, consent, rehab, family booking and complete logs/card. - Complete signatures/paperwork. - Finalize financial agreement and payment setup. - Demonstrate rehab exercises. - Schedule family check at clinic expense. - Complete new-patient checklist and log. - Record important computer notes and correct travel-card markings. - Confirm understanding, appointment commitment and exercise plan; source also seeks financial/referral commitment. Workflows: grow-day3 Scripts: Uncertainty: ['Faint reverse-side show-through is visible, but no additional front-side wording is legible.', 'Recaptured duplicate/near-duplicate of IMG_0275; source spelling/layout differences remain visible. Merge operational execution with canonical source rather than schedule a second workflow.'] Disposition: duplicate ### IMG_0397 · Room 4 retention intervention and handoff Private discussion for missed visits, money, commitments, calendars or any barrier; details preparation and receptionist-to-enrollment handoff. - Trigger private Room 4 when missed visits, finances, commitment, calendar or other continuation barrier appears. - Prepare financial audit, recommendation/adherence review, films and notes if possible. - Without time, inspect card, financials/payments/calendar and known facts. - Address actual problem and all other concerns; if information missing, set follow-up meeting. - If needs recommitment, source reviews films and four questions. - Receptionist routes patient into room, pulls/displays films and alerts enrollment. Workflows: grow-room4 Scripts: grow-room4-question Uncertainty: ['Recaptured duplicate/near-duplicate of IMG_0277; source spelling/layout differences remain visible. Merge operational execution with canonical source rather than schedule a second workflow.'] Disposition: duplicate ### IMG_0398 · Room 4 and testimonial interview duplicate Duplicate substantive text of IMG_0371 without adjacent-page fragments. - Same private issue and testimonial-discovery workflow as IMG_0371; no second workflow instance. Workflows: grow-testimonial, grow-room4 Scripts: Uncertainty: ['Recaptured duplicate/near-duplicate of IMG_0371; source spelling/layout differences remain visible. Merge operational execution with canonical source rather than schedule a second workflow.'] Disposition: duplicate ### IMG_0399 · Re-exam and re-report practice Purpose, timing, content and outcomes for recurring review, including worse-film branch continued next page. - Re-exam every 12 visits or earlier if disengaging; can occur on table or in room. - Repeat positive tests; measure progress; review four questions about findings/impact/progression/commitment. - Review home rehab, kept appointments and barriers. - If improving request referrals/testimonials; if not make recommendations. - Re-report films usually 2–3 months or 24–36 visits, or when more information is needed. - For monthly patient, source suggests films every 12 visits (yearly). - Report goals: measure/show progress, recommit and referrals. - Improved-film script compares first/follow-up, records percent and communicates clinician schedule change. - If worse first verify marking accuracy; next page adds positioning and clinical branch. Workflows: grow-reexam, grow-rereport Scripts: grow-rereport-improved Uncertainty: ['Recaptured duplicate/near-duplicate of IMG_0310; source spelling/layout differences remain visible. Merge operational execution with canonical source rather than schedule a second workflow.'] Disposition: duplicate ### IMG_0400 · Worse follow-up film review Only foreground continuation belongs here: check positioning/marks, defer report if corrections required, consider clinical causes if technically correct. - Check positioning as well as marks before interpreting worsening. - If inaccurate, source says remark or retake and perform re-report next visit. - If technically accurate, clinician evaluates rehab and source explanation of early worsening; do not auto-excuse deterioration. - Historical source says early worsening may occur especially in the first 30 days and therefore places the first follow-up film at least at the two-month mark. Preserve this rationale as review-only; it is not an approved explanation of deterioration or an automatic imaging order. Workflows: grow-rereport Scripts: Uncertainty: ['Faint underlying-sheet text is excluded from the primary transcription; the source image remains available.', 'Inspected image directly: foreground is worse-film continuation; faint underlying re-exam page is separately captured as IMG_0401. Record title in earlier metadata is misleading and corrected here.', 'Recaptured duplicate/near-duplicate of IMG_0311; source spelling/layout differences remain visible. Merge operational execution with canonical source rather than schedule a second workflow.'] Disposition: duplicate ### IMG_0401 · Twelve-visit re-exam and imaging re-report handoff Operational visit-based review checklist, Initial Progress Report and imaging-to-front-desk RR scheduling. - Pull films before shift; receptionist recognizes every 12-visit grey line. - First re-exam: patient completes Initial Progress Report before adjustment, attach to travel card and address issues before visit ends. - After adjustment, examiner takes patient into exam room with films; doctor covers if enrollment unavailable. - Repeat positive tests; ask four questions; review exercises/heel lift/attendance/barriers; ask referrals/testimonials if appropriate. - Mark #2 in exam area, circle RE in comments, return card to front desk. - For second/third review with imaging, source says generally 24–36 visits but also before end of card or 35th visit. - Doctor indicates requested films after adjustment, mark exam section/circle RE 3, take films and escort to reception to schedule RR. Workflows: grow-reexam, grow-rereport Scripts: grow-reexam-questions Uncertainty: ['The symbol preceding the main heading appears to be δ; its exact glyph is somewhat ambiguous in the photograph.', 'Direct image inspection confirms both conflicting thresholds: before 35th and between 24th–36th. Needs clinician/owner resolution, not silent normalization.', 'Recaptured duplicate/near-duplicate of IMG_0309; source spelling/layout differences remain visible. Merge operational execution with canonical source rather than schedule a second workflow.'] Disposition: duplicate ### IMG_0402 · Travel-card clinical notes, billing evidence and next visit Baseline technique, response-based revisions, durable note transfer and accurate billing/scheduling markings. - At first adjustment document technique/procedure baseline in comments. - If response favorable maintain approach; if not clinician adjusts technique/speed/force. - Source mentions 72 hour favorable impression and possibly twice-daily care; clinician-only judgment, not automatic schedule rule. - Circle useful established notes so they transfer to future cards. - Mark imaging and exams in correct areas to support billing. - Check next-visit calendar is correctly marked and remind patient. Workflows: grow-travel-card Scripts: grow-next-visit Uncertainty: ['Numbered 5,6,9 are blank in source; no missing instructions invented.', 'Recaptured duplicate/near-duplicate of IMG_0300; source spelling/layout differences remain visible. Merge operational execution with canonical source rather than schedule a second workflow.'] Disposition: duplicate