Mental Status Exam
Appearance: [select name="race" value="White|Black|Hispanic|"][conditional field="race" condition="(race).is('')"] [text ][/conditional] [select name="sex" value="male|female|transgender female|transgender male"], appearing [select name="appearance" value="approximately same as|younger than|older than"] chronological age, [checkbox name="build" value="normal build|overweight|obese|underweight|emaciated|thin|muscular build|wearing hospital gown|wearing paper scrubs|wearing street clothes|oddly dressed|partially undressed|malodorous"][select name="grooming" value=", adequate hygiene and grooming|, disheveled appearing|, well-groomed|, grooming notable for"] [text].
Attitude/Behavior: [checkbox name="attitude" value="lying down in bed|sitting up in bed|sitting on side of bed|sitting in bedside chair|pacing, walking around room|calm|irritable|restless|agitated|impatient|guarded|defensive|argumentative|resistant to psychiatry|poor effort and cooperation|cooperative|uncooperative|eventually cooperates|reluctantly cooperates|intermittently cooperative|easily engages|difficult to engage|socially appropriate|socially inappropriate at times|disinhibited behavior|grimacing with positional changes|lying in urine|lying feces|poor social awareness"] [text size=65 value='']; [select name="eyecontact" value="fair|good|poor|intermittent|intense|refuses|no"] eye contact.
Motor activity: [checkbox name="motor" value="increased level of activity|decreased level of activity|psychomotor agitation|psychomotor retardation|no abnormal movements|tremulousness|+tremor-|+tic-|+dystonia-|+catatonia as evidence by"] [text size=65]
Mental Status Exam
Appearance: , appearing chronological age, .
Attitude/Behavior: ; eye contact.
Motor activity:

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.67, 13 form elements, 13 boilerplate words, 4 text boxes, 3 checkboxes, 5 drop downs, 1 conditionals, 61 total clicks
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