[textarea name="variable_1" default="Patient that presents today via Telehealth complaining of fever"]
[text name="variable_1" default="Symptoms have been present since"]
[date name="variable_1" default="06/26/2020"]
Nature of fever:
[select name="variable_1" value="Intermittent:High temperature present only for some hours of the day and remits to normal for the remaining hours | Remittent: Temp is above normal throughout the day and fluctuates more than 1 degree celsius in 24 hours |Low grade fever: Evening rise of temp for several days but does not exceed 100 F at any time|Septic fever :Temp varies but peaks are very large (over 102.5 F) and the changes in temp exceed 5 C"]
[radio name="variable_1" value=" Accompanied by no other symptoms|Presence of chills and rigor|Accompanied by fatigue,myalgias, headache, loss appetite or nausea | RED FLAGS confusion, AMS, seizures, hemoptysis, severe abdominal pain, intractable headache, decrease urine output, neck rigidity, dyspnea, hematemesis or melena ---> NEEDS TO GO TO THE ED IMMEDIATELY"]
[checkbox name="variable_1" value=" Needs ER immediately|Needs UC immediately|Follow-up with PCP within 10 days| Needs to enroll with PCP ASAP, information given"]
[checklist name="variable_1" value="|chills|dry cough|Hemoptasis|SOB|headache|nausea or vomiting|nasal congestion or discharge|dizziness|anosmia|Ageusia"]
PHONE/VIDEO EXAM: (vitals to be added into addendum)
GENERAL: Alert, calm, conversant in NAD
ENT: No dysphonia.
LUNGS: Unlabored respirations, speaking in full sentences
NEURO: Normal speech. Alert and oriented.
PSYCHIATRIC: Normal mood. Normal insight and judgement.