Hypertension/Elevated blood pressure A/P

[var name="***Hypertension/Elevated blood pressure***"]
Blood pressure noted [select name="BP" value="consistently at/below goal|consistently elevated above goal|uncontrolled"].
Goal BP is [select name="goalbp" value="<130/80|<140/90|other"][text name="goalbp" default=""].
Patient[select name="BPoutcome" value="has achieved BP goal| has not met bp goal| has been non compliant with antihypertensives"].
[comment memo="interventions to date"]
***Patient [select name="variable_1" value="monitors BP at home|does not monitor BP at home|does not have BP cuff at home"]and readings have been [select name="variable_2" value="normal|at goal|elevated|unknown"]
Non-pharm interventions tried-
[checkbox name="Non-pharm" value="diet|exercise|smoking cessation|weight loss|other"]
[comment memo="list specifics of non-pharm interventions here"][text name="Non-pharm" default=""]
Testing/Labs:[select name="labs" value="checking kidney/liver function|Creatinine|BUN|K|Na|CMP"] 
Treatment/Medications:[select name="Treatment/Medications" value="none|ACE|ARB|thiazide|Beta Blocker|Ca Channel Blocker|other"] [select name="MEDaction" value="stopped|continued|added|changed"]
Referrals:[select name="Referrals" value="None|Nephrology|Cardiology|Vascular|other"]
Follow-up:[select name="Follow-up" value="2 weeks|1 month|3 months|6 months|1 year|as needed"]
[conditional field="diet" condition="Limiting sodium intake to 2,400 mg per day is recommended to lower blood pressure. Limiting sodium intake to 1,500 mg per day provides additional benifit."]A diet that emphasizes vegetables, fruits, and whole grains is recommended to lower BP. Limiting sodium intake to 2,400 mg per day is recommended to lower blood pressure. Limiting sodium intake to 1,500 mg per day provides additional benifit. [/conditional]
***Hypertension/Elevated blood pressure***
Blood pressure noted .
Goal BP is .
Patient.
interventions to date
***Patient and readings have been
Non-pharm interventions tried-

list specifics of non-pharm interventions here
Testing/Labs:
Treatment/Medications:
Referrals:
Follow-up:

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.85, 17 form elements, 21 boilerplate words, 2 text boxes, 1 checkboxes, 10 drop downs, 1 variables, 2 comments, 1 conditionals, 17 total clicks
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