Cognitive Problems History
[select name="Q1" value="no|YES"] <-- Changes in memory (is the patient misplacing things more, using notes and reminders more, repeating questions, having trouble keeping track of dates and appointments?)[conditional field="Q1" condition="(Q1).is('YES')"]
Details --> [textarea][/conditional]

[select name="Q2" value="no|YES"] <-- Changes in language (word-finding difficulties?)[conditional field="Q2" condition="(Q2).is('YES')"]
Details --> [textarea][/conditional]

[select name="Q3" value="no|YES"] <-- Changes in visuospatial function (new driving difficulties, including being slow to identify roadway hazards, late to apply brakes, or difficulty staying in lane?)[conditional field="Q3" condition="(Q3).is('YES')"]
Details --> [textarea][/conditional]

[select name="Q4" value="no|YES"] <-- Changes in attention/executive function (easily distracted, new difficulties preparing meals or using household appliances, new difficulty writing checks, new safety concerns from family members?)[conditional field="Q4" condition="(Q4).is('YES')"]
Details --> [textarea][/conditional]