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Upload a Medicare evaluation PDF — we'll extract the data and let you confirm before saving.

Drop your evaluation PDF here
Initial PT / OT / SLP evaluation from a Medicare-compliant agency
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Extracting patient data… this takes about 5–10 seconds
PDF uploaded and data extracted — review below before confirming.
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Extracted Fields
Demographics
Full Name
Date of Birth
MRN
Phone
Address
Emergency Contact
Contact Name
Contact Phone
Referral
Referral Source
Referring Physician
Diagnosis
Primary Diagnosis
ICD-10 Codes
Plan Details
Onset Date
Frequency
Duration
Payer Type
Certification Period
Plan Start Date
Cert Period End Date *
This date feeds the recert alert system — ensure accuracy
Goals & Function
Prior Level of Function
Short-Term Goals
Long-Term Goals
Precautions & Status
Precautions
Weight-Bearing Status
Homebound Justification
Therapist Name & Credentials
Original PDF
original-evaluation.pdf
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original-evaluation.pdf
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