Injury History

Onset [text] prior to evaluation
Onset while:  [text]
Injury at [text]

Associated Pain (0=none, 10=severe)
Location: [text]
Radiation: [text]
Severity now (0-10): [text]
Severity at worst (0-10): [text]
Duration: [text]
Characterized as [text].
Onset prior to evaluation
Onset while:
Injury at

Associated Pain (0=none, 10=severe)
Location:
Radiation:
Severity now (0-10):
Severity at worst (0-10):
Duration:
Characterized as .

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0, 9 form elements, 24 boilerplate words, 9 text boxes, 9 total clicks
Questions/General site feedback · Help Ticket

2 responses to “Injury History”

    • Mark Morgan says:

      yes – I’m sorry – I was nervous there could be a security issue with that feature.

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