test 3

MSE
Appearance: [select name="variable_1" value="Appropriately dressed/well groomed|disheveled|inappropriately dressed|neglected"].
Distinguishing features:[text name="variable_1" default="sample text"].
Weight:[select name="variable_1" value="recent weight gain|recent weight loss|no change"].
Personal hygiene:[text name="variable_1" default="sample text"].
Clothing:[select name="variable_1" value="appropriate for the weather/circumstances |inappropriate for the weather/circumstances"].
Objects:[text name="variable_1" default="sample text"].
Engagement/Rapport: [select name="variable_1" value="cooperative|guarded|suspicious|paranoid|engaged|warm|distracted"].
Eye contact: [select name="variable_1" value="good|fair|poor|fleeting|avoidant"].
Psychomotor activity:[text name="variable_1" default="sample text"].
Speech: [select name="variable_1" value="pressured|slow|normal range|emotional|monotonous| minimal|absent|excessive|within normal limits"].
Mood: [text name="variable_1" default="sample text"].
Affect: [select name="variable_1" value="congruent with mood, stable|fixed|restricted|Labile|heightened|blunted|flat|incongruent with mood"].
Thought process: [select name="variable_1" value="linear, goal-directed, coherent|loose associations|circumstantial thoughts|tangential thoughts|Flight of ideas|Thought blocking|perseveration|neologisms"].
Thought content: [select name="variable_1" value="no delusions present|obsessions|compulsions|overvalued ideas|preocuppied with delusions"].
Suicidal Ideation: [select name="variable_1" value="none present|passive ideation, no plans or intent|activally suicidal"].
Homicidal/violent thoughts:[select name="variable_1" value="none present|passive ideation, no plans or intent|activally homicidal"].
Thought possession: [select name="variable_1" value="thought insertion|thought withdrawal|thought broadcasting|none present"].
Perception: [select name="variable_1" value="hallucinations|Psuedo-hallucinations|illusions|depersonalisation|derealisation|none present"].
Cognition: [select name="variable_1" value="alert and oriented to time, place and person|"].[select name="variable_1" value="x1|x2|x3|x4"].
Insight: [select name="variable_1" value="good|fair|poor|impaired|limited"].
Judgement: [select name="variable_1" value="good|fair|poor|impaired|limited"]