FACT RN Individual Participant Note

[textarea name="variable_1" default="Participant  presented to FACT Team Office today for"]
[checkbox name="variable_1" value="pre-scheduled appointment With: |court hearing|random urinary drug screen|therapy group|medication refills|administration of long acting injectable medication"]

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.5, 2 form elements, 1 text areas, 1 checkboxes, 7 total clicks
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