Newborn First Visit

Patient is a [text] day Old [select value= "Select|M|F"] that presents to clinic for a well child check. 
Parental concerns: [textarea default="Post Partum Depression:"]. 
Complications during pregnancy/delivery: [textarea default=]
How many wet diapers: [text]
Sleep/Naps: sleeps [text] hours at night and naps [text]. Patient sleeps [textarea default= "location"]
Food: 
[textarea default= "Breast/Formula:Frequency of feeds: How much: Time spent eating: Vitamin D drops for breast fed infants, 400 IUs daily, Iron supplement for pre-me 1mg/kg"]
Child care:
[textarea default= "When are you going back to work, child care?"]
Home: 
[textarea default= "Who lives at home: Siblings: Parents occupation:"]
Safety: [checklist value= "Put to sleep on back|No blankets, pillows or toys in crib|Firm mattress|Rear facing car seat|Never left unattended on raised surfaces"]
[textarea default="Meds: Allergies: PMH: PSH: FH:"]
[comment memo="PE: **Red reflex"]