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INTRODUCTION

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Subject ID

Age (yrs)

Clinical Setting

Sex

Dx

# Impairment Goals

# Functional Goals

# Social Goals

Total Goals

# Measurable Impairment Goals

# Measurable Functional Goals

# Measurable Social Goals

01

18

1

1

719.42

2

2

1

5

2

1

0

02

40

2

2

719.42

2

4

1

7

2

1

1

03

47

3

1

719.42

5

1

1

7

4

0

1

04

37

3

2

719.42

3

2

2

7

3

2

1

05

22

1

1

719.42

1

2

1

4

1

1

0

06

53

2

1

719.42

4

2

2

8

2

1

0

07

45

3

2

719.42

4

3

0

7

4

2

0

08

69

2

1

719.42

0

4

0

4

0

1

0

09

48

1

1

719.42

2

4

1

7

1

1

1

10

16

3

2

719.42

3

1

2

6

1

2

1

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