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"]. Motor Milestones: [checklist value= "head flops back|hands in fists moving in front of mouth/face|Tummy time"][text] Social/Language Milestone: [checklist value= "eyes wander|turns to sounds"] 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"]
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Sandbox Metrics: Structured Data Index 0.29, 15 form elements, 36 boilerplate words, 4 text boxes, 6 text areas, 3 check lists, 1 drop downs, 1 comments, 21 total clicks
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