Course Completion & Follow-Up
A summary at the end of a TCM course — comparing baseline and current status, reviewing pattern resolution, and laying out a discharge or maintenance plan.
Course period (e.g. Mar 2025 – May 2025):
Total sessions completed:
Formulas used during the course:
[Issuer enters this at creation]
Baseline vs. Current — Symptom Comparison
Chief complaint at baseline (0 = none, 10 = worst):
Chief complaint right now (0 = none, 10 = worst):
Rate sleep, digestion, energy, and mood from 1 (poor) to 5 (excellent), at baseline and now:
Sleep — baseline: current:
Digestion — baseline: current:
Energy — baseline: current:
Mood — baseline: current:
Functional impact — baseline (work / family / daily life):
[Issuer enters this at creation]
Tongue & Pulse Re-Assessment
Lifestyle / Diet Adherence
Adherence rating (1 = poor, 5 = excellent):
What worked well in the lifestyle plan?
[Issuer enters this at creation]
What was hard to keep up with?
What was hard to maintain?
Any side effects experienced during the course:
[Issuer enters this at creation]
LFT (ALT/AST) values, if checked:
RFT (Cr/eGFR) values, if checked:
Notable herb reactions or interactions to record for the chart:
[Issuer enters this at creation]
Continuation / Maintenance Plan
Specific recommendations for the next phase:
[Issuer enters this at creation]
Western specialist (name / specialty):
Dietary counselling resource:
Mind-body therapy (qi gong / tai chi / meditation / counselling):
Overall rating (1 = poor, 5 = excellent):
Testimonial — what the patient would like to share about the experience:
[Issuer enters this at creation]
Clinical observations, formula adjustments that worked best, lessons learned for similar cases:
[Issuer enters this at creation]
Thank you for completing this course. May your qi flow smoothly and your body, mind, and spirit stay in harmony.