Free checklist

The First Assessment Checklist

19 steps for your first session with an MSK patient, from the first question to the treatment decision, each with one line on why it matters and what it changes. Built to upgrade your SOAP notes, not replace them.

Free PDF, 3 pages
Red flag screen included
Use it on your next patient

“I don't ask that question. And if I did, I wouldn't know what to do with the answer.”

If that sounds familiar, you're not missing knowledge. You're missing the link between the question and the decision. This checklist puts that link on paper.

A physiotherapist guiding the raised arm of a patient lying on a treatment table — A shoulder assessment in clinic

What's inside

Every step of your first session with an MSK patient, from history to treatment decision, and why it matters. Red flag screen included.

Page 1: history questions, each with the reason behind it

Page 2: red flag screen, hypotheses and decisions

Page 3: quick reference table and common mistakes

Send me the checklist

Page 1 · Step 1 (S)
10 history questions with the reason behind each so every answer moves you closer to a hypothesis instead of filling the notes.
From the checklistAsk the patient to point to the pain with one finger. One finger usually means a local problem. The whole hand means think referred pain or a wider driver.
Page 2 · Step 2 (O)
A red flag screen (fracture, infection, malignancy, cauda equina, DVT, vascular), so you know when to stop and refer.
From the checklistMalignancy: history of cancer, unexplained weight loss, constant pain unchanged by position or rest.
Page 2 · Step 3 (A/P)
The finding → structure → treatment chain so you can explain to the patient, in two sentences, what's wrong and why you're treating it this way.
From the checklistMovement X reproduced the pain → structure Y is the likely source → so we load, unload or mobilise Y in this way.
Page 2 · Step 3 (A/P)
The continue / change / refer rule for every review session.
Page 3
A quick-reference table and the 4 most common mistakes to keep next to your notes until the reasoning becomes automatic.

Who it’s for

For you if

You're in your first years of practice or final year of study.
You work without day-to-day supervision, so nobody checks your reasoning.
You finish first sessions unsure what your findings actually mean.

Not for you if

You're looking for a new hands-on technique to add.
You want a fixed protocol rather than a way of thinking. This is about how you reason during an assessment, not what you do with your hands.

What changes in your first session

Without itWith the checklist

You ask every question on the form, and the answers end up in the notes.You know what each answer changes, so it ends up in the decision.

You examine everything "just in case".You start from 2–3 hypotheses and know what you are looking for.

You give the treatment you always give.You can write the chain: finding → structure → treatment.

You can't tell whether the session helped.You recheck the comparable sign before the patient leaves.

From physios who learnt to reason, not guess

Built from 10 years in clinic and mentoring 40+ physiotherapists. 17 of them share their experience on video.

Original WhatsApp message in Croatian — Mentorship graduate, message to Franjo

Original WhatsApp chat in Croatian — Mentorship graduate, chat with Franjo

In their own words · English subtitles

1:43

“A patient walks into the treatment room, starts describing their symptoms, and you know exactly what's going on and how to help them: what to focus on, what to release, what to activate and how to test.”

Tina TomićMentorship graduate

1:01

“I'd often help a client, or not, but sometimes I didn't understand why. Now, from the first session I know what I'm dealing with and what needs rehab.”

Vladimir ŠestoŽivot Rehabilitation Centre

2:05

“Before, I was afraid of assessments. Now within the first few minutes of a patient arriving we find the problem.”

Filip RajkovićMentorship graduate

1:40

“Before, I struggled to find the cause and make a diagnosis. Now, just minutes after a client walks in, we find the cause and set out a plan for their rehab.”

Marko RadošPhysiotherapist in Germany

Vanja Vranješ, video testimonial — **Vanja Vranješ**Mentorship graduate

Neven Grabovac, video testimonial — **Neven Grabovac**Život Rehabilitation Centre

Ivica Karoglan, video testimonial — **Ivica Karoglan**Owner, Risorius Physiotherapy Centre

Google reviews

What trainees say about the Noxana internship

Kenan co-founded the Noxana rehabilitation centre in Mostar, which runs an internship for physiotherapy students and young physios. These are the interns’ public Google reviews.

★★★★★

“The internship at Noxana was a great experience, especially for those just starting out. Lots of useful knowledge, practical experience, and a great atmosphere. Highly recommended!”

MajaGoogle review · Noxana internship

★★★★★

“Kudos to the entire Noxana team and their internship program. A lot of interesting things were seen and learned in these 4 weeks, kudos to the mentors for their patience and way of transferring knowledge. Definitely recommend to all students to enroll in the program.”

Karla GalicGoogle review · Noxana internship

★★★★★

“I had the opportunity to participate in training at the rehabilitation center Noxana. The staff is professional and friendly. Access to patients and therapies are very professional. I gained a lot of necessary knowledge for the future. A very nice experience”

Anel KekicGoogle review · Noxana internship

Who’s behind this

Two physiotherapists who still treat patients every day, in Croatia and Bosnia and Herzegovina.

Franjo Keškić mobilising the flexed hip and knee of a patient lying on a treatment table — **Franjo Keškić**MSc Physiotherapy

Kaštel Sućurac, Croatia

Franjo Keškić

Founder, Fizio Centar Keškić, Kaštel Sućurac, Croatia

Around 10 years in practice. Franjo came into physiotherapy after his own football injury was misdiagnosed. That experience is why the first assessment and clinical reasoning sit at the centre of everything he teaches.

He has personally mentored 40+ students and physiotherapists through his 1:1 programme, and teaches anatomy and biomechanics as a guest lecturer at the Život Physiotherapy Academy.

~10 years in practice
40+ physios mentored 1:1
Guest lecturer, Život Academy

Kenan Gosto testing a patient’s hip in flexion on a treatment table — **Kenan Gosto**MSc Physiotherapy

Mostar, Bosnia and Herzegovina

Kenan Gosto

Co-founder, Noxana physiotherapy and rehabilitation centre, Mostar, Bosnia and Herzegovina

Kenan has worked with elite athletes, including the Bosnia and Herzegovina national swimming team at European championships and European champion Lana Pudar. Alongside that, his daily caseload runs from recreational athletes to chronic pain patients.

He teaches colleagues and students through mentoring and practical workshops such as Physiotherapy 101.

BiH national swimming team
European champion Lana Pudar
Physiotherapy 101 workshops

“Find the cause of the dysfunction. Don't just treat the place that hurts.”

The First Assessment Checklist

The First Assessment Checklist

Get the free checklist

What's inside

Who it’s for

What changes in your first session

From physios who learnt to reason, not guess

What trainees say about the Noxana internship

Who’s behind this

Franjo Keškić

Kenan Gosto

Stop guessing in the first session.

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