3 Year WCC

Patient is a [text] YO [select value= "Select|M|F"] that presents to clinic for annual well child check. 
Parental concerns: [textarea default= "recent illness, behavior problems, development"]. 
Motor Milestones:
[checklist value="Can put some clothes on|Feeds self with fork|Jumps in place|pedal a tricycle"]
Social/Language Milestone:
[checklist value="Notices other kids and wants to play|Calm down within 10 minutes after drop off at daycare|Most people can understand their speech|Knows name"]
Sleep/Naps: sleeps [text] hours at night and naps [text]
Potty Training readiness:
[checklist value="showing intrest|completely potty trained|dry naps|indicates need to use bathroom"][text]
Food: 
[textarea]
Child care:
[checkbox value="daycare|stays at home|both daycare and home"] [text]
Home: 
[textarea default= "Who lives at home: Siblings: Parents occupation:"]
Activities: [textarea default="Hobbies: Physical Activity: Reading:"]
Screen Time:[text default="sample text"]
Dentist: [checkbox value="Sees dentist on a regular basis|Going to establish|No dental visits"] [comment memo="Consider fluoride tx"] [text]
Safety:[checklist value="Wears Helmet|Cleaning supples stored safely|Supervised outside play|in properly sized carseat|Swimming lessons|Tobacco exposure"][text]
[textarea default="Meds: Allergies: PMH: PSH: FH:"]
[comment memo="PE: **Red reflex"]