DISCHARGE ORDERS-NPNE

[select name="variable_dcor" value="DISCHARGE ORDERS for|AMA DISCHARGE ORDERS for"] [date name="variable_1" default=""] (see notes for details)
HOME PHARMACY: [textarea name="variable_2" default=""]
___________________________________
**MAR MEDICATIONS** Patient may discharge with ACTIVE medications on the MAR 
[checkbox name="variable_des" value="*** Destroy the following    medications"][textarea name="variable_3" default=""]

[comment memo="✔ HOME MED LIST"]
**HOME MEDICATIONS** [checkbox name="variable_homemed" value="No home medications brought in on admission|May discharge with all home medications"] [checkbox name="variable_exc" value="except for:"][textarea name="variable_4" default=""]

**PRESCRIBED MEDICATIONS** The following  prescriptions sent to home pharmacy: [textarea name="variable_1" default=""]

**OTC MEDICATIONS** Advise patient to pick up OTC medications: [checkbox name="variable_132" value="multivitamin|melatonin|thiamine|folic acid|flonase|zyrtec|claritin|nicotine replacement"] [textarea="variable_3" default=""]
[checkbox name="variable_ecept" value="**EXCEPTIONS** These specific medications should be sent home with patient (they will not be Rx'd to home pharmacy):"][textarea name="variable_22" default=""]
[checkbox name="variable_202" value="**FOLLOW UP** The patient should follow up with PCP regarding the following medications (as these were not Rx'd):"]
[textarea name="variable_32" default=""]


(see notes for details)
HOME PHARMACY:

___________________________________
**MAR MEDICATIONS** Patient may discharge with ACTIVE medications on the MAR


✔ HOME MED LIST
**HOME MEDICATIONS**


**PRESCRIBED MEDICATIONS** The following prescriptions sent to home pharmacy:


**OTC MEDICATIONS** Advise patient to pick up OTC medications:






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Sandbox Metrics: Structured Data Index 0.53, 16 form elements, 37 boilerplate words, 7 text areas, 1 dates, 6 checkboxes, 1 drop downs, 1 comments, 23 total clicks
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