List of After Hours Consults

Consult #: [text name="variable_1" default="]   
Callback #: [text name="variable_6" default="]   
Service: [text name="variable_2" default=""]                   
MRN: [text name="variable_3" default=""]   
Location: [text name="variable_4" default=""]   
Reason for consult: [textarea name="variable_5" default=""]
Consult #:
Callback #:
Service:
MRN:
Location:
Reason for consult:

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0, 6 form elements, 8 boilerplate words, 5 text boxes, 1 text areas, 6 total clicks
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