Vascular

year-old 
[text name="variable_1" default="sample text"] with a past medical history of 
[checkbox name="variable_1" value="HLD|HTN|CAD|T2DM|PAD|CVI|DEMENTIA|CVA|MI"] presents for 
[select name="variable_1" value="vascular screening|vein counseling|pad counseling"]. 
[textarea name="variable_1" default="sample text"] Patient 
[select name="variable_1" value="admits|denies"]
[checkbox name="variable_1" value=" Aching|cramping|pain in their arms, buttocks, thighs, or legs when walking|Pain or discomfort in their feet or toes while lying in bed at night"] [checkbox name="variable_1" value="after walking 1 block|after walking several blocks|climbing a flight of stairs] [checkbox name="variable_1" value="painful sores or ulcers on their legs or feet|discolored, pale or bluish arms or legs|numbness, weakness or feeling of heaviness of muscles|cold sensation of the skin of their legs and feet|burning sensation of their feet or toes"]. [select name="variable_1" value="Denies|Admits"] being diagnosed with PAD. Patient is a [checkbox name="variable_1" value="current smoker|former smoker|never smoked"]. Patient is 
[select name="variable_1" value="compliant|non-compliant|never tried compression stockings|not interested in compression stockings"]. Patient 
[select name="variable_1" value="is currently taking NSAIDs|is currently not taking any NSAIDs"]

Physical Exam
General: [select name="variable_1" value="Comfortable, Well-developed, Well-Nourished|Obese"]
Heart: [checkbox name="variable_1" value="S1S2, RRR, no murmurs, rubs, or gallops"]
Lungs: [checkbox name="variable_1" value="CTABL with no rales, rhonchi, or wheezes."]
Neuro: [checkbox name="variable_1" value="A&Ox3, CN 2-12 GI|Peripheral sensation impaired|peripheral sensation intact|Short term memory impaired"]
Extremities: 
[checkbox name="variable_1" value="Reticular veins|Telangiectasias|Varicose veins|Corona phlebectatica|
[text name="variable_1" default="sample text"] Pitting edema|Non-pitting edema|Kaposi-stemmer sign 
[text name="variable_1" default="sample text"]|Healed ulcers of the [text name="variable_1" default="sample text"]|Active ulcers of the [text name="variable_1" default="sample text"]"]