School Refusal HPI

[textarea fillable="true" name="hpidetails" cols="75" rows="15"]Age:***years***
pt wish to come for consult?: ***yes/no***
Start - link with anything: ***yes/no***
duration: ******
child view: ******
parents view: ******
schools view: ******
refusing other situations?: ***yes/no***
Any friends truant?: ***yes/no***
impact - home: ******
impact - school: ******
mood sx: ******
anxiety sx: ***bullying? oc? something about school or teacher?***
psychotic sx: ******
substance use: ***yes/no***
Ctrl + (or )

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0, 1 form elements, 1 text areas, 1 total clicks
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