Create flat file from data download

I am having some difficulty taking a raw data download and making it into a flat file. Would it be possible to help me with the code to generate the flat file from exisitng data?

I attached a sample spreadsheet with input as I get it (merged and missing two columns of data) and also an output version showing what I hope to eventually achieve.

I added a column for "Site" and one for "Therapy". Getting those new columns populated in VBA is the toughest challenge for me (but by no means the only one). Another part I struggle with a bit is that some cells are merged.

Any help is greatly appreciated.

-Michael