Psychiatry Outpatient Note T-chart

[textarea name="variable_1" default=""]
[checkbox name="1" value="The patient presents in good controls and is pleasant and open upon approach. "]
[text name="Mood" default="The patient reports they having been feeling "][select name="variable_3" value="good|neutral|depressed|anxious|sad|happy|fine"]
[text    name="RatingD" default="The patient reports"][select name="variable_1" value="0|1|2|3|4|5|6|7|8|9|10"][text name="Ratingscale2" default="/10 depression and "][select name="variable_1" value="0|1|2|3|4|5|6|7|8|9|10"][text name="Ratingscale3" default="/10 anxiety. "]
[text name="Sleep" default="Sleep has been "][select name="variable_3" value="good|poor|improving|worsening|baseline|same"][text name="Appetite" default="and appetite has been "][select name="variable_3" value="good|poor|improving|worsening|baseline|same"]
[checkbox name="One" value="The patient denies acute concerns. "]
[checkbox name="Two" value="The patient denies new stressors since last appointment. "]
[checkbox name="Four" value="Pt denies suicidal thoughts, homicidal or aggressive thoughts, or hallucinations. "]
[text name="space"]
[checkbox name="Three" value="The patient states they are taking their medications consistently.  "]
[checkbox name="Five" value="Pt denies adverse effects to medications. "]
[checkbox name="Six" value="Pt reports they feel their medications have been working well and decreasing their symptoms. "]
[checkbox name="Seven" value="They report the following side effects to medications: "]
[checkbox name="Sideeffects" value="nausea|GI upset|headaches|dizziness|trouble sleeping|restlessness|lower appetite|constipation|drooling"]
[checkbox name="ROS" value="ROS: pt denies vision changes, involuntary movements, dizziness, and has been toileting appropriately. "]
[text name="space"]
[checkbox name="plan1" value="Psychoeducation regarding tobacco cessation provided."]
[checkbox name="plan2" value="Psychoeducation regarding proper sleep hygiene provided."]
[checkbox name="plan3" value="Psychoeducation regarding proper diet provided and discussed."]
[checkbox name="plan4" value="Routine labs ordered"]
[checkbox name="plan5" value="Lab tests reviewed and discussed"]
[checkbox name="plan6" value="Prior records reviewed"]
[checkbox name="plan7" value="Side effects to all new medications as well as the alternative treatment options discussed"]
[text name="FU" default="Follow up in "][select name="variable_6" value="1|2|3|4"][text name="FU2" default=" months"]























Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.68, 34 form elements, 10 text boxes, 1 text areas, 17 checkboxes, 6 drop downs, 42 total clicks
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