WCC 6-11

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. Activities: Subject in school you enjoy: Subject in school you are good at: What do you want to be when you grow up: "]
Home: [textarea default= "who lives at home: siblings: Parents occupation: How much sleep per night:"]
Food: [textarea default= "School Lunch, Home Lunch"]
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:[checklist name="variable_1" value="Wears Helmet|Knows address|Knows phone number|Swimming lessons"][text]
[textarea default="Meds: Allergies: PMH: PSH: FH:"]
[comment memo="PE: **Red reflex"]
[comment memo= "Time spent reading"]
[comment memo="Immunizations@11:    TdaP.    Menactra,    Gardisel"]
Patient is a YO presents to clinic for annual well child check.
Parental concerns:





Screen Time:

Dentist: Consider fluoride tx

PE: **Red reflex
Time spent reading
Immunizations@11: TdaP. Menactra, Gardisel

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.25, 16 form elements, 23 boilerplate words, 2 text boxes, 7 text areas, 1 checkboxes, 1 check lists, 1 drop downs, 4 comments, 17 total clicks
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