ROS: Genitourinary

GENITOURINARY: [checkbox name="variable_137" value="Deferred"]
Foley catheter in situ? [checkbox name="variable_138" value="Yes|No"]
Suprapubic catheter in situ?
     If yes: [checkbox name="variable_139" value="Indwelling|Intermittent"]
Frequency of change? [text name="variable_18" default="Every _ weeks"]
Date of last change: 
[text name="variable_19" default=""]
Dysuria? [checkbox name="variable_140" value="Yes|No"]
Increased urinary frequency? [checkbox name="variable_141" value="Yes|No"]
Bladder spasms? [checkbox name="variable_142" value="Yes|No"]
Flank pain? [checkbox name="variable_143" value="Yes|No"]
Hematuria? [checkbox name="variable_144" value="Yes|No"]
Malodour? [checkbox name="variable_145" value="Yes|No"]
Frothy? [checkbox name="variable_146" value="Yes|No"]
Colour change: 
[checkbox name="variable_147" value="Dark|Cloudy|Concentrated"]
Retention (Difficulty initiating stream)? [checkbox name="variable_148" value="Yes|No"] 
Incomplete evacuation of bladder? [checkbox name="variable_149" value="Yes|No"]
Nocturia? [checkbox name="variable_150" value="Yes|No"]
Foley catheter in situ?
Suprapubic catheter in situ?
If yes:
Frequency of change?
Date of last change:

Increased urinary frequency?
Bladder spasms?
Flank pain?
Colour change:

Retention (Difficulty initiating stream)?
Incomplete evacuation of bladder?

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.88, 16 form elements, 40 boilerplate words, 2 text boxes, 14 checkboxes, 30 total clicks
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