Medical Cannabis Telehealth

Visit:
[checkbox value="Telehealth. |Office Visit. |Telephone"] [textarea]

CC:
[checkbox value="pain |nausea |cancer |seizures |glaucoma |crohn's |PTSD |hepatitis C |HIV |AIDS |muscle spasms |cachexia |agitation of Alzheimer's |ALS"]

Condition Associated:
[checkbox value="Cachexia/Wasting syndrome |PTSD 
|Severe or chronic pain |Severe nausea |Severe or persistent muscle spasm |Seizures"]

HPI:
Patient presents for [checkbox value="an initial MMJ certification. |a MMJ certification renewal. |a MMJ consultation. "] [textarea]

SH:
Alcohol: [checkbox value="none |rarely |occasionally |regularly "] [text]
Tobacco: [checkbox value="none |cigarettes |pipes |vape |chew/dip "] [text]
Work: [checkbox value="none |retired |disabled |full time |part time |student |stay-at-home parent"] [text]


GENERAL APPEARANCE
[textarea default="Alert. No distress. Well-nourished and developed."]

GAIT
[textarea default="Normal base, balance, stride mechanics, and turns."]

ROS: Attached 

Assessment: [checkbox value=" Patient Qualify for Medical Cannabis Program NYS 12 months |Patient Qualify for 3 month MCP NYS |Patient does not qualify"] [text]

Plan: 
[checkbox value=" Patient to have 3 month follow up after beginning Cannabis Medicine |Patient to inform all providers of use of cannabis medicine. |Patient to sign the Cannabis use agreement"] [text]
Visit:


CC:


Condition Associated:


HPI:
Patient presents for


SH:
Alcohol:
Tobacco:
Work:


GENERAL APPEARANCE


GAIT


ROS: Attached

Assessment:

Plan:

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.5, 18 form elements, 19 boilerplate words, 5 text boxes, 4 text areas, 9 checkboxes, 57 total clicks
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