Cardiac H&P and SOAP

[date name="variable_1" default="12/03/2020"]
Chief Complaint: [text name="" default=""]
[text name="" default=""] yr old [select name="" value="male|female"] presents to [select name="" value="clinic|ED"] for [textarea name="" default=""]

Code Status: 
[select name="" value="Full Code|DNR|DNI"]

PMHx: 
[checkbox name="" value="Reviewed|Noncontributory"][textarea name="" default=""]
PSHx:[checkbox name="" value="Reviewed|Noncontributory"][textarea name="" default=""]
FMHx: [checkbox name="" value="Reviewed|Noncontributory"][textarea name="" default=""]
Medications:
[textarea name="" default=""]
Allergies: 
[checkbox name="" value="NKDA|NKFA"][textarea name="" default=""]

Soc: [textarea rows="2"][checkbox value="reviewed|noncontributory"]
-Tobacco- [select name="Tobacco" value="denies/never|previous-|current-"][conditional field="Tobacco" condition="(Tobacco).is('previous-')"][select value="Tobacco|Vape|Chew"] - [text size="7"] [select value="pack(s)/day|can(s)/wk|recharge(s)/pod(s)/wk"] x [text size="4"]yrs, quit [text size="4"]yrs ago, denies current use[/conditional][conditional field="Tobacco" condition="(Tobacco).is('current-')"][select value="Tobacco|Vape|Chew"] - [text size="7"] [select value="pack(s)/day|can(s)/wk|recharge(s)/pod(s)/wk"] x [text size="4"]yrs[/conditional]
-EtOH- [select name="EtOH" value="denies/never|previous-|current-"][conditional field="EtOH" condition="(EtOH).is('current-')"][text size="3"] [select value="cans of beer|glasses of wine|shots of whiskey"] [select value="daily (average)|weekly (average)|on weekends only|rarely on special occasions"] for [text size="4"]yrs[/conditional][conditional field="EtOH" condition="(EtOH).is('previous-')"] quit [text size="4"] years ago, denies current use[/conditional]
-Illicit drugs- [select name="illicitdrugs" value="denies/never|previous-|current-"][conditional field="illicitdrugs" condition="(illicitdrugs).is('previous-')"][text size="50"] x [text size="4"]yrs, quit [text size="4"]yrs ago[/conditional][conditional field="Tobacco" condition="(Tobacco).is('current-')"][text size="50"] x [text size="4"]yrs[/conditional]
-Living situation- [text default="lives with" size="60"]

Physical Exam: 
GEN - [text name="" default=""]
[checkbox name="" value="well developed|well nourished|A&Ox4"]
HEENT - [text name="" default=""]
[checkbox name="" value="Normocephalic |atraumatic|conjunctiva clear|sclerae aninteric|TMs with clearly visible landmarks|nares patent|mucous membranes moist|throat nonerythematous/noninjected|good dentition"]
Neck - [text name="" default=""]
[checkbox name="" value="soft/supple|no JVD|no thyromegaly|no tender/enlarged lymph nodes"]
Chest - [text name="" default=""]
[checkbox name="" value="normal rise and fall B/L|No accessory muscle use"]
Heart - [text name="" default=""]
[checkbox name="" value="RRR|no murmur|normal S1/S2|no friction rub|no S3/S4 ausculatated"]
Skin - [text name="" default=""]
[checkbox name="" value="warm|pink|dry|no edema"]

Review of Systems:
Constitutional [text name="" default=""]
[checkbox name="" value="fever|chills|malaise|unexplained wt gain/loss"]
HEENT [text name="" default=""]
[checkbox name="" value="vision changes|hearing changes|smell changes|nose sx|throat sx|ceck sx"]
Resp [text name="" default=""]
[checkbox name="" value="cough|shortness of air"]
CV [text name="" default=""]
[checkbox name="" value="cough|SOA"]
GI [text name="" default=""]
[checkbox name="" value="abd pain|nausea|vomutubg|diarrhea|constipation"]
GU [text name="" default=""]
[checkbox name="" value="urinary frequency|yrubart urgency|pain with urination"]
MSK [text name="" default=""]
[checkbox name="" value="new/unusal muschle aches|new/unusal muschle aches"]

EKG
[select name="" value="none|reviewed-"]
[text name="" default="findings"]
Labs 
[select name="" value="none|reviewed-"]
[text name="" default="findings"]
Radiology
[select name="" value="none|reviwed-"]
[text name="" default="findings"]

_____________________________________________________________________________

#[text memo="dx" memo_size="small" size="60"]
[textarea discussion/plan" cols="100" rows="6"]
[comment memo="Drop-downs for add'l problems" memo_size="small"]
[checkbox name="Problem1" value="#"][conditional field="Problem1" condition="(Problem1).is('#')"][text memo="dx" memo_size="small" size="60"]
[textarea memo="discussion/plan" memo_size="small" cols="100" rows="6"]

[/conditional][checkbox name="Problem2" value="#"][conditional field="Problem2" condition="(Problem2).is('#')"][text memo="dx" memo_size="small" size="60"]
[textarea memo="discussion/plan" memo_size="small" cols="100" rows="6"]

[/conditional][checkbox name="Problem3" value="#"][conditional field="Problem3" condition="(Problem3).is('#')"][text memo="dx" memo_size="small" size="60"]
[textarea memo="discussion/plan" memo_size="small" cols="100" rows="6"]

[/conditional][checkbox name="Problem4" value="#"][conditional field="Problem4" condition="(Problem4).is('#')"][text memo="dx" memo_size="small" size="60"]
[textarea memo="discussion/plan" memo_size="small" cols="100" rows="6"]

[/conditional][checkbox name="Problem5" value="#"][conditional field="Problem5" condition="(Problem5).is('#')"][text memo="dx" memo_size="small" size="60"]
[textarea memo="discussion/plan" memo_size="small" cols="100" rows="6"]

[/conditional][checkbox name="Problem6" value="#"][conditional field="Problem6" condition="(Problem6).is('#')"][text memo="dx" memo_size="small" size="60"]
[textarea memo="discussion/plan" memo_size="small" cols="100" rows="6"]

[/conditional]Chronic Medical Conditions: [select name="Chronic" value="none|as follows"]
[conditional field="Chronic" condition="(Chronic).is('as follows')"][textarea default="#dx - stable. no issues. continue current home treatment/meds." cols="80" rows="10"]

[textarea name="" default="Signature"]
[date name="" default="12/03/2020"]