Allergy & Otolaryngology
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HPI:
Team member presents today with
[checkbox name="sx" value="dry cough|productive cough|sore throat|swollen lymph nodes|post nasal drip|runny nose|nasal congestion|shortness of breath|headache|sinus headache|chest congestion|dizziness|ear pain|ear pressure|tinnitus|watery eyes|itchy eyes|red eyes|skin irritation|***"]
These symptoms started [select name="sxduration" value="today.|yesterday.|2-3 days ago.|earlier this week.|last week.|over a week ago.|a month ago.|over a month ago."]

[select value="He|She"]
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


Evaluation:

In the office today I


Additional Notes:



Plan:

Result - Copy and paste this output:

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