CURRENT MENTAL HEALTH TREATMENT

Current Psychotherapy:
[select name="currenttherapy" value="Client denied receiving any current mental health therapy or psychotherapy from outside providers|Client endorsed currently receiving psychotherapy from"] [text name="therapist" default="sample text""].

Current Psychiatric Medication(s):
[select name="currentmeds" value="Client denied any current use of psychiatric medications|Client endorsed taking the following psychiatric medication(s):"] [select name="variable_1" value="|fluoxetine (Prozac)|sertraline (Zoloft)|escitalopram (Lexapro)|citalopram (Celexa)|Vilazodone (Viibryd)|Aripiprazole (Abilify)|Duloxetine Cymbalta)"] [text name="andmed" default="sample text""].
Current Psychotherapy:
.

Current Psychiatric Medication(s):
.

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.6, 5 form elements, 6 boilerplate words, 2 text boxes, 3 drop downs, 5 total clicks
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