vascular fu

[text name="variable_1" default="sample text"] year-old 
[checkbox name="variable_2" value="male|female"] with a past medical history of [checkbox name="variable_3" value="HLD|HTN|CAD|T2DM|PAD|CVI|DEMENTIA|CVA|MI"] presents for [select name="variable_4" value="fu s/p varithena|s/p angiography|vein counseling|pad counseling"]. 

[checkbox name="variable_8" value="Patient tolerated the procedure well and their post-operative course was uneventful|Patient did not tolerate the procedure well|Patient denies any acute complaints at today's visit|Patient denies new skin ulcers, hair growth change, sob at rest/exertion, chest pain, palpitations, heaviness, achiness, fatigue, leg pain at rest, blue/purple discoloration of the hands and feet, n/v/d/c, fever, chills"]

All 12 ROS negative except for those mentioned above.

diagnosed with [select name="variable_7" value="PAD requires further evaluation with angiography|CVI currently being treated with varithena injections|PAD & CVI requiring further evaluation with angiography|PAD & CVI currently being treated with varithena injections"]
year-old
with a past medical history of presents for .



All 12 ROS negative except for those mentioned above.

diagnosed with

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.83, 6 form elements, 19 boilerplate words, 1 text boxes, 3 checkboxes, 2 drop downs, 18 total clicks
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