Physiotherapy prescription generator

Clinic & doctor

Logo

PNG or JPG, shown on the prescription letterhead

Clinic name

Doctor / physiotherapist name

Qualification

Registration no.

Clinic address

Clinic phone

Clinic email (optional)

Saved details auto-load next time you open this tool.

Patient name

Date

Age

Sex

Country code

WhatsApp / contact number

Diagnosis / chief complaint

Choose exercise (grouped by category)

Video link auto-fills with a matching Physiomobility exercise-library page (editable — paste your own link anytime).

or add an exercise not in the list

#	Exercise	Dosage	Video link (optional)

No exercises added yet — pick one above.

Draw with mouse or finger. This is an electronic signature capture, not a certified digital signature.