Start: The Athlete and the Moment

• Tell me the story of how this injury or concern started, in your own words.
• When did the injury occur and what were you doing at the time? Options: During competition, During practice, During weight training, Gradual/overuse, Found on screening, Other
• Describe any imaging, tests, or treatments already completed, and when they happened.
• How would you rate your typical pain level and functional limitation today, and does it change with sport-specific movements? Options: Minimal, Mild, Moderate, Severe, Varies with activity
• Who currently handles your day-to-day care, such as an athletic trainer, therapist, parent, or team physician? Options: Athletic trainer, Team physician, Family member, Local therapist/clinic, No one dedicated, Other
• Which timeline matters most to you: a single match, finishing the season, the draft/tryout window, or a longer career goal? Options: Next match, Finish current season, Draft/tryout window, Career longevity, Other

What This Is Costing You Right Now

• If this injury kept you out of the next season, what concrete cost would that be to your scholarship, contract, or career trajectory?
• How has your performance in practice or games changed since the injury started? Options: Minor differences, Big drop in ability, Noticeable but manageable, No change observed
• In concrete terms, which sport skills are most affected: acceleration, cutting, jumping, throwing velocity, endurance, or confidence under contact? Options: Acceleration/speed, Cutting/deceleration, Jump height, Throwing/serve velocity, Endurance, Confidence under contact, Other
• When you picture returning at full capacity, what specific movements or skills are non-negotiable for you?
• What single outcome would make you walk away from any proposed plan immediately? Options: Loss of career-critical function, Unacceptable out-of-pocket cost, Timeline that misses key event, Lack of named clinical lead, Other

Who Needs Convincing and What They Want

• Who besides you will sign off on care decisions and what would make them say no?
• List each stakeholder's role, their decision authority, and the primary outcome they care about.
• Which channels do team staff, family, and coaches prefer for updates, and who should receive objective test results first? Options: Direct phone, Secure portal message, Email, Team meeting, Athletic trainer only, Other
• Provide the contact and role of the person who can obtain prior records, imaging, or outside reports if we need them quickly.
• If a recommended plan changed your season timeline by more than 6 weeks, who would be enabled to veto it? Options: Athlete, Parent/guardian, Team physician, Coach/GM, Athletic director/school, Other

Clinical Targets That Would Feel Like Success

• Name the single objective test or performance marker that would convince you and your team you are ready to compete again. Options: Strength symmetry %, Hop/functional test benchmarks, Throwing/serving velocity, Pain-free full practice, Sport-specific drill completion, Other
• Share your view on surgical versus non-surgical options when the goal is returning to elite play, and any prior experiences that shape that view. Options: Prefer surgery if it shortens risk, Prefer conservative first, Open to either with clear plan, Undecided, Other
• Specify target timelines for milestones like pain control, jogging, sport-specific drills, and final clearance. Options: 0-4 weeks, 4-8 weeks, 8-16 weeks, 4-6 months, 6-12 months, Season-dependent
• What objective thresholds do you expect for strength, hop testing, range of motion, or sport-specific velocity?
• Should those thresholds not be met within your target season, would you prefer to extend the timeline or pursue a different provider? Options: Extend timeline with same team, Seek different provider, Reassess based on progress, Undecided

What Could Break This Plan

• Identify the top three medical or non-medical complications that would force you to stop or change course. Options: Complication requiring re-op, Insurance denial, Academic or team conflict, Travel or housing limits, Inability to access specialist, Other
• State the maximum period you can tolerate uncertainty about recovery before you would look for alternative options. Options: 1 week, 2-4 weeks, 1-2 months, More than 2 months, Depends on the stage
• Have insurance limits, prior authorization denials, or out-of-pocket cost concerns ever interrupted your care? Options: Yes, frequently, Occasionally, Once, Never, Not sure
• List the non-medical constraints, such as travel, school, or team obligations, that could force a change in the plan.
• Is there any red line in timing, cost, or personnel that would make you stop and require a different approach?

Who Else You Are Considering

• Tell me which other care options you are evaluating or have used recently, including staying with current team staff or managing it internally. Options: Current team medical staff, Local general orthopedist, Specialist surgical center, Rehab-only provider, Attempt to manage internally, No alternatives yet, Other
• For your incumbent provider or internal plan, what would have to change for you to stay with them instead of switching?
• Has anyone on your team proposed handling diagnosis or rehab without an outside specialist, and who suggested that? Options: Yes, team staff suggested, Yes, family suggested, No one suggested, Not sure
• Point to specific parts of existing care that meet your needs and specific parts that clearly fall short.
• Assuming your current option matched the objective return-to-play metrics we discussed, what would still keep you from staying? Options: Trust in clinician experience, Access to sport-specific rehab, Cost differences, Timelines, Other

Practical Readiness and Constraints

• Identify the approvals, schedules, and facility access that must be secured on your side for treatment to start on your ideal timeline.
• Do you have completed imaging, operative notes, or specialist reports accessible for review, and if not, who can obtain them? Options: All available and uploaded, Some available, will provide, Need help obtaining records, Not available
• Provide the contact and role of the person who will coordinate authorizations and scheduling and describe their capacity to act quickly.
• Are there league, school, or regulatory approvals required before you can return to competition? Options: Yes, league clearance, Yes, school medical board, No external approvals, Not sure
• Point to a single logistical failure that would force a delay or cancellation of the plan. Options: Insurance denial, No OR or rehab slot available, Key clinician unavailable, Athlete unavailable due to obligations, Other

Agreeing Success and Next Steps

• Assuming a short pilot proved we could meet your key milestones, what would prevent you from signing within that week? Options: Funding/insurance hold, Stakeholder approval delay, Need more evidence, Scheduling conflicts, Other
• Describe the decision criteria leadership will use to approve the final care plan and authorize funds or scheduling.
• Provide the names, roles, and preferred contact methods of the people who need to attend the final care plan review and who must sign off.
• State the acceptable timeline to begin treatment after final agreement, from immediate to a specific number of weeks. Options: Start immediately, Within 1-2 weeks, Within 3-4 weeks, 1-2 months, Depends on approvals
• Provide the payment, insurance, and consent items that must be resolved before we book the first appointment and who owns each task.

• Treatment Options & Rehabilitation Pathway Session

• Confirm the current state and its cost
• You confirm the recommended treatment options map directly to the documented clinical findings and that the risks and expected recovery windows are understood.
• Deliver a one-page treatment options summary with estimated timelines, risks, and recommended objective tests within three business days.
• Draft a proposed rehabilitation milestone schedule tied to objective return-to-play criteria for review before the follow-up meeting.
• Map clinical findings to treatment options
• You confirm the proposed rehab pathway meets the athlete's performance goals and competition timeline or surface acceptable trade-offs.
• Show the sport-specific rehabilitation pathway and gating criteria
• You confirm the objective return-to-play criteria and milestone gates that will be used to clear the athlete for sport.
• Provide the athlete's baseline functional test results, competition calendar, and primary stakeholder contact information prior to the follow-up decision session.
• You agree on the remaining evidence or stakeholder approvals required to finalize the treatment decision.
• Align timelines to the athlete's goals and stakeholders
• Validate the plan with you
• Agree next steps and decision criteria

• Treatment Options & Rehabilitation Pathway Session
• Treatment & Rehabilitation Solution Deck
• Treatment & Rehabilitation Solution Brief

• meeting
• slides
• document

• Arthroscopic ACL reconstruction
• Meniscal repair and preservation
• Arthroscopic rotator cuff repair
• Shoulder labral repair and stabilization
• Concussion management and supervised RTP
• Operative fixation for stress fractures
• Image-guided injection therapies
• Immediate postoperative rehabilitation (Weeks 0–4)
• Progressive sport-specific rehabilitation (Weeks 4–12)
• On-field functional progression and sport simulation
• Objective return-to-sport testing battery
• Postoperative bracing and custom orthosis fitting

Arthroscopic ACL reconstruction

• Confirm whether arthroscopic ACL reconstruction is the planned index procedure for the athlete's current episode of care (based on consult and imaging). Options: Yes, No, Undecided / needs further evaluation
• Identify the preferred graft source for reconstruction (attach rationale from the last surgical consult or prior operative report if available). Options: Bone-patellar tendon-bone autograft, Hamstring (semitendinosus) autograft, Quadriceps tendon autograft, Allograft, Undecided
• Indicate the planned fixation method for femoral and tibial tunnels (e.g., interference screw, suspensory cortical fixation) and any device constraints from prior hardware. Options: Interference screw, Suspensory cortical fixation, Button fixation, Anchor/other, Plan not decided
• Attach the most recent knee imaging status (MRI report and date; list presence of bone bruise, concomitant meniscal pathology). Options: MRI with full radiology report (uploaded), MRI available but report pending, No MRI yet, Other imaging (CT/X-ray) available
• State the target functional milestone timeline (in weeks) you require for return-to-running and return-to-sport after ACL reconstruction. Options: Return-to-running <16 weeks, 16-24 weeks, 24-36 weeks, 36+ weeks, Undetermined
• Name the operating surgeon or clinical lead who will own the operative plan and be the signatory for surgical consent.

Meniscal repair and preservation

• State the meniscal tear type and location from the MRI report (e.g., posterior horn medial, root tear, radial) that you plan to address with repair/preservation.
• Specify the repair technique preference if known (all-inside, inside-out, outside-in, root fixation) and whether a concomitant procedure (e.g., ACL reconstruction) is planned. Options: All-inside, Inside-out, Outside-in, Root fixation, Technique undecided
• Indicate weightbearing and knee-flexion restrictions you will require post-repair during Weeks 0–6 (e.g., partial weightbearing, restricted flexion arc). Options: Protected weightbearing (NWB) 2 weeks, Partial weightbearing (PWB) 4 weeks, Weightbearing as tolerated (WBAT), Restrict flexion to 0-90 degrees, No specific restrictions
• List any intraoperative or implant constraints that would change the planned rehabilitation (e.g., peripheral meniscal repair requiring longer protection, root repair needing delayed loading).
• Identify the expected documentation to be provided after surgery to define rehab anchors (operative note, intra-op photos, post-op protocol). Options: Operative note, Intra-op images, Standardized post-op protocol, No documents yet
• Specify the CPT or billing code guidance to confirm coverage considerations for meniscal repair if known.

Arthroscopic rotator cuff repair

• From the shoulder MRI report, indicate tear size and tendon(s) involved (e.g., supraspinatus full-thickness 2 cm).
• Choose the repair construct preference if applicable (single-row, double-row, transosseous-equivalent) and whether augmentation is planned. Options: Single-row, Double-row, Transosseous-equivalent, Augmentation planned, Undecided
• State the expected immobilization period and sling protocol (weeks) that should be reflected in the post-op care plan. Options: Immobilizer 1 week, Sling 2 weeks, Sling 4–6 weeks, No sling beyond immediate post-op
• Provide the shoulder range-of-motion (ROM) and strength milestones you require at 6 and 12 weeks for phased progression.
• Confirm whether the athlete's sport requires early overhead-specific conditioning that will change the rehab timeline (e.g., baseball pitcher, volleyball). Options: Yes — overhead athlete, No — non-overhead, Undetermined
• Name the therapist or clinic that will be the primary point-of-contact for supervised rotator cuff rehab (if already selected).

Shoulder labral repair and stabilization

• Select the labral pathology described on imaging or exam that you plan to address (Bankart, SLAP, posterior labral tear, multidirectional instability). Options: Bankart (anterior), SLAP, Posterior labral tear, Multidirectional, Other/unspecified
• Indicate whether this is a contact athlete or overhead throwing athlete, and the athlete's sport position, to anchor functional goals.
• Specify anchor type preference and any constraint that the rehabilitation team must follow (e.g., number/placement of suture anchors noted in operative plan). Options: Suture anchor standard, Knotless anchors, Other, Undecided
• State the immobilization and external rotation restriction timeline that will define weeks 0–4 care. Options: Sling only, Sling with ER block 4 weeks, Sling 2 weeks then progressive
• List objective instability or exam findings that will be rechecked prior to advancing sport-specific loading.
• Identify any existing shoulder stability baseline tests (e.g., prior functional testing, isokinetics) to compare post-op progress. Options: Baseline isokinetics available, Baseline field test data available, No baseline data

Concussion management and supervised RTP

• Confirm whether baseline neurocognitive testing data (SCAT5, ImPACT or equivalent) is available for the athlete and attach date. Options: Baseline neurocognitive test available, No baseline available, Baseline incomplete
• Specify whether formal neuropsychology assessment or computerized testing will be required before graded return-to-play. Options: Formal neuropsychology required, Computerized testing only, No additional testing required
• Name the clinical owner who will track concussion symptoms and sign off on each graded exertion step.
• State the symptom and cognitive recovery thresholds you will use for progression (for example: symptom-free at rest and symptom provocation < X on exertion and baseline neurocog within Y% of prior).
• Indicate whether vestibular/ocular motor therapy sessions are required as part of supervised return-to-play. Options: Yes — vestibular/ocular therapy required, No, Undecided
• Provide preferred documentation format for concussion clearance (signed clearance form, timed progress notes, test score printouts). Options: Signed clearance form, Progress notes with test scores, Electronic report upload, Other

Operative fixation for stress fractures

• Specify the anatomic location and chronicity of the stress fracture from imaging that requires fixation (e.g., femoral neck tension-side, navicular, tibial cortex).
• Attach the most recent imaging modality indicated for fixation planning (CT preferred for navicular/femoral neck) and note date. Options: CT with report, MRI with report, X-ray only, No imaging uploaded
• Indicate fixation hardware preferences or constraints (e.g., retrograde intramedullary screw, plate and screws) and whether bone grafting is expected. Options: Intramedullary screw, Plate and screws, Compression screw, Bone grafting planned, Undecided
• State the post-op weightbearing progression required (NWB, PWB, WBAT) and the earliest weeks for progressive loading you will allow. Options: Non-weightbearing 4 weeks, Partial weightbearing 6 weeks, WBAT immediately, Other
• Confirm whether bone stimulation adjuncts (e.g., PEMF, low-intensity pulsed ultrasound) are requested and need procurement or authorization. Options: Yes — bone stimulator required, No, Undecided
• Provide the key radiographic healing endpoints you will require before advancing to sport-specific impact loading.

Image-guided injection therapies

• Select the injection therapies you want available for this episode (diagnostic injection, corticosteroid, platelet-rich plasma, hyaluronic acid, other). Options: Diagnostic anesthetic injection, Corticosteroid injection, Platelet-rich plasma (PRP), Hyaluronic acid, Other
• Indicate the image guidance modality preferred for injections (ultrasound, fluoroscopy, or landmark-guided when appropriate). Options: Ultrasound guidance, Fluoroscopy, Landmark-guided, Undecided
• State the maximum number of injection procedures planned for this condition within a 12-month period for scope and authorizations. Options: Single injection, 1–2 injections, 3+ injections, Undecided
• Confirm the activity restrictions you will require post-injection (rest hours, modified training days) for each injection type. Options: 24 hours rest, 48 hours rest, Modify training for 7 days, No restriction specified
• Provide any required consent or documentation language required by payors for biologic injections that needs to be included in the care plan.
• Indicate whether ultrasound-guided injection slot availability and clinic capacity are constraints for scheduling (affects timeline). Options: Capacity constrained — lead time >7 days, Capacity available — lead time <7 days, Undecided

Immediate postoperative rehabilitation (Weeks 0–4)

• Define the supervised visit frequency you want in Weeks 0–4 (visits per week) and whether home-exercise monitoring is required. Options: 0–1 visits/week, 2 visits/week, 3+ visits/week, Home-exercise monitoring required
• Specify the wound, pain, and basic mobility thresholds that will define readiness to advance from Week 0–4 to Progressive Rehabilitation (Week 4).
• Identify immediate post-op weightbearing and brace instructions to be included verbatim in the discharge protocol (e.g., NWB 2 weeks, hinged brace locked in extension). Options: NWB, PWB, WBAT, Hinged brace locked, No brace
• Name the primary rehabilitation clinician who will document each week 0–4 visit and be the contact for early complications.
• State the expected documentation artifacts we should receive at 2-week and 4-week checkpoints (wound photos, pain scores, ROM measures). Options: Wound photos + progress note, Pain scores + ROM measures, Full visit note only, Other
• Indicate whether thromboprophylaxis or other immediate post-op medical orders must be coordinated with primary care or cardiology (if required). Options: Yes — thromboprophylaxis, No, Undecided

Progressive sport-specific rehabilitation (Weeks 4–12)

• Describe the sport-specific drills or movement patterns that must be included between Weeks 4–12 based on the athlete's position and sport.
• Select the therapy frequency you expect during this phase and whether sessions must include supervised gym/field time. Options: 1 session/week, 2 sessions/week, 3+ sessions/week, Include supervised field sessions
• State the measurable strength and ROM targets at Week 8 and Week 12 that will be used to authorize progression to field work.
• Indicate whether instrumented metrics (force-plate, isokinetic testing) will be used in this phase and which ones. Options: Force-plate jump metrics, Isokinetic knee testing, Wearable GPS/accel metrics, No instrumented metrics
• Specify how communication with the athlete's coaching staff should be handled when rehab milestones impact practice availability. Options: Weekly summary to coach, As-needed alerts when milestones missed, Coach excluded from clinical notes
• Identify any external facility access requirements for the athlete (athletic training room, turf field, weight room) to execute sport-specific drills.

On-field functional progression and sport simulation

• List the sport-specific on-field drills and contact progression sequence you require for graded exposure (e.g., agility ladder, controlled contact, full-contact scrimmage).
• Name the clinician who will supervise on-field sessions and the required clinician-to-athlete ratio for safe simulation.
• Identify protective equipment or custom taping that must be used during on-field simulation (brace model, padding, cut-resistant sleeves). Options: Hinged knee brace, Functional ACL brace, Shoulder immobilizer, Custom taping, No special equipment
• Indicate facility and scheduling constraints for on-field work (available turf hours per week, daylight requirements, indoor backup).
• Provide the field-based performance thresholds (time, distance, tolerated contact) that will define progression to full contact and game clearance.
• State whether GPS/accelerometer load targets (e.g., % of pre-injury peak load) should be enforced during simulation sessions. Options: Yes — use % of pre-injury load, No — do not use GPS targets, Undecided

• Master Services Agreement (MSA)
• Statement of Work (SOW) — Care Plan
• Informed Consent for Treatment and Procedures
• Financial Responsibility and Payment Authorization
• Insurance Authorization and Prior Authorization Release
• HIPAA Authorization & Notice of Privacy Practices Acknowledgement
• Release for Care Coordination with Team and Third Parties
• Parental/Guardian Consent for Minors
• Cancellation, Rescheduling, and No-Show Policy
• Telehealth Consent (if applicable)

• Initial Clearance Health Check
• First Outcome Review (weeks 4-10)
• Acceptance Gate — Clearance Decision (around day 90)
• Quarterly Post-Clearance Follow-up

• Maintain the shared issues channel and ensure named clinical contact details are current for escalation.
• Update the rehab plan to reflect agreed adjustments and publish the revised schedule.
• Schedule the next objective testing session and confirm clinician responsible for administering and documenting results.
• Restate numeric acceptance criteria
• Produce a documented clearance decision that records pass/fail per acceptance criterion from Care Plan & Scope.
• For any failed criteria, agree a remediation plan with owners and dates that will be tracked to closure.
• Record the formal clearance decision and associated test results in the shared medical record and the journey workspace.
• Publish remediation plans for any failed criteria with owners and re-test dates.
• If cleared, confirm the preferred communication channel and next scheduled surveillance check.
• Review reinjury and complication events
• Confirm that reinjury rate and patient-reported function remain within acceptable bounds or identify cases needing intervention.
• Capture at least two concrete process or clinical improvements to reduce future risk and assign follow-up tasks.
• Open follow-up care tickets for any athletes with new symptoms or sub-threshold function and assign resolution timelines.
• Update the maintenance protocol and patient education materials based on lessons learned.
• Reconfirm acceptance criteria and owners
• All outstanding documentation and required objective tests are identified and a plan to complete them is agreed.
• Named clinical owner is confirmed for each open issue and short-term remediation actions have timelines.
• Complete and upload any missing objective test results and consent documents to the shared record.
• Schedule any corrective testing or imaging within the next 14 days.
• Document owners and due dates for each blocker in the shared issues channel.
• Present first outcome data vs Care Plan & Scope targets
• Determine whether the percentage of objective RTP tests passed and time-to-clearance are trending toward the targets recorded in Care Plan & Scope.
• Agree a corrective action plan with owners and dates to address any shortfalls before the acceptance gate.
• Deliver the outcome dataset showing test-by-test pass/fail results and cumulative pass rate to the shared workspace within 5 business days.
• Validate completion of required objective tests
• Present outcome data against each criterion
• Assess patient-reported sport function and maintenance adherence
• Diagnose root causes for any metric gaps
• Capture lessons learned and process improvements
• Adjust rehabilitation progression or testing schedule
• Early adherence and symptom report
• Document pass/fail decisions and capture formal clearance
• Confirm shared follow-up channel and escalation path
• Agree remediation for any failed criteria
• Assign corrective actions and owners
• Open issues and immediate blockers
• Agree immediate remediation actions
• Confirm data collection and reporting cadence