Renal Calculi f/u

[text size="3"] yo [select value="female|male"] presents to the clinic today for follow up for 
[select value="right|left"] 
[checkbox value="ESWL|cystouretoroscopy with stone basket extraction"].  
[checkbox value="Pt symptoms of renal colic relieved follow procedure.  Pt doing wll today with no urinary complaints."]
[checkbox value="Pt complains of"]
[checkbox value="dysuria|frequency|urgency|nocturia
|urge incontinence|stress incontinence|post-micturition dribble|hematuria|cloudy urine|malodorous urine| fever|chills|vaginal discharge|Pelvic pain|flank pain"]. 
[checkbox value="Pt symptoms from of renal colic relieved after procedure, pt doing well at this time."]
[checklist value=Pt denies"][checkbox value="dysuria|frequency|urgency|nocturia
|urge incontinence|stress incontinence|post-micturition dribble|hematuria|cloudy urine|malodorous urine| fever|chills|vaginal discharge|Pelvic pain|flank pain"].
[checkbox value="ureteral stent remains in place since surgery."]
[checkbox" value="Symptoms consistent with ureteral stent presence"].
[checkbox value="UA|PVR|KUB|RUS|CT of ABD/Pelvis with/without contrast|CT of ABD/Pelvis without contrast"] obtained and reviewed.  
UA revealed:  PVR:  KUB 
[checkbox name= value="Urine culture ordered"], 
[checkbox value="will call pt when culture has resulted, if postive culture, will prescribe appropriate abx therapy at that time|will start pt on abx therapy at this time and review therapy choice when culture results, and call if change in abx therapy is needed"]
[checkbox value="Cystoscopy performed, ureteral stent removed intact in clinic today."]

Pt to f/u in clinic in [text size="3"] 
[checklist value="days|week(s)|month(s)|year(s)"] for 
[checkbox value="UA|PVR|KUB|RUS"].


Informed the pt if symptoms worsen to call the clinic for immediate follow-up, if clinic isn't open, report to the ED, otherwise follow up to the clinic as instructed in HPI for f/u.
yo presents to the clinic today for follow up for

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.

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obtained and reviewed.
UA revealed: PVR: KUB
,



Pt to f/u in clinic in
for
.


Informed the pt if symptoms worsen to call the clinic for immediate follow-up, if clinic isn't open, report to the ED, otherwise follow up to the clinic as instructed in HPI for f/u.

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.89, 19 form elements, 59 boilerplate words, 2 text boxes, 13 checkboxes, 2 check lists, 2 drop downs, 60 total clicks
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