WCC 12-18

Patient is a [text] YO [select value= "Select|M|F"] presents to clinic for annual well child check. 
Parental concerns: [textarea default= "recent illness, behavior problems, development"]. 

School/Academics:[textarea default= "In ** grade and attends ** School. Subject in school you enjoy: Subject in school you are good at: Activities: What do you want to be when you grow up: **15 and up** Plans after highschool:"]
Home: [textarea default= "who lives at home: siblings: Parents occupation: How much sleep per night:"]
Food: [textarea]
Activities: [textarea default="Hobbies: Physical Activity: Something youre good at: "]
Screen Time:[textarea]
Dentist: [checkbox value="Sees dentist on a regular basis|Going to establish|No dental visits"] [comment memo="Consider fluoride tx"]
Safety:[textarea default="Safe sex practice: Alcohol use: Drug use: Unsafe behavior:"][text]
[textarea default="Meds: Allergies: PMH: PSH: FH:"]

[comment memo="Immunizations@16    2nd    dose    Meningococccal"]

Patient is a YO presents to clinic for annual well child check.
Parental concerns:





Screen Time:

Dentist: Consider fluoride tx

Immunizations@16 2nd dose Meningococccal

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.17, 14 form elements, 23 boilerplate words, 2 text boxes, 8 text areas, 1 checkboxes, 1 drop downs, 2 comments, 14 total clicks
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