Basic Note

HPI:
Team member presents today with 
[textarea name="typehere" cols="50" rows="5"] 
These symptoms started 
[textarea name="typehere" cols="50" rows="5"]
[select value="He|She"] feels the most pain when 
[textarea name="typehere" cols="50" rows="5"] 
[select value="He|She"] has [checklist name="tried" value="not tried anything for these symptoms. |tried|tylenol|ibuprofen|heat|ice|icy hot|stretching|using a brace|working with ergo|"]
Evaluation:
[textarea name="typehere" cols="50" rows="5"]
In the office today I
[checkbox name="inoffice" value="iced the area for 10min|applied biofreeze to the area|gave oral ibuprofen|gave oral tylenol|provided the team member with a soft brace|formed a sam splint for the team member|contacted Ergo to evaluate|Scheduled an appointment for the team member at mainsite|provided stretches via handout"]

Additional Notes:
[textarea name="typehere" cols="50" rows="5"]


Plan: 
[checkbox name="Recommended" value="Ice 10-15min twice daily as needed|Take Ibuprofen every 6-8 hours as needed|Take Tylenol as needed|Rotate between ibuprofen and tylenol every 4 hours as needed|Perform provided stretches 3-5 times daily|Apply biofreeze to the area 2-3 times daily as needed|Wear brace while working, remove during break and at night|Follow up with Ergo, I will notify Ergo to do an assessment|Follow up with health services in 2-3 days if no improvement|See provider at Mainsite"]
HPI:
Team member presents today with

These symptoms started

feels the most pain when

has
Evaluation:

In the office today I


Additional Notes:



Plan:

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.5, 10 form elements, 24 boilerplate words, 5 text areas, 2 checkboxes, 1 check lists, 2 drop downs, 37 total clicks
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