Procedure Note
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CONSENT:
[checkbox name="consent" value="procedure, risks, benefits, alternatives explained|patient/SO voiced understanding & agreed to proceed|consent signed|verbal consent obtained"]

TETANUS:
[checkbox name="tetanus" value="up to date|less than five years ago|5-10 years ago|greater than 10 years ago|unknown"]

NAIL: [select name="Q2" value="right|left"][conditional field="Q2" condition="(Q2).is('other - ')"][text][/conditional][checkbox value="medical|lateral||first|second|third|fourth|fifth"][textarea cols=40 rows=1]

SURROUNDING SKIN:
[checkbox name="skin" value="induration|swelling|tenderness|erythema|"][textarea cols=40 rows=1]
REGIONAL:
[checklist name="regional" value="lymphangitis|LAD"][textarea cols=40 rows=1]

PREP:
[checkbox name="prep" value="tourniquet applied|draped to expose area|povidone-iodine applied|"][textarea cols=40 rows=1]
ANESTHESIA:
[checkbox name="anesthesia" value="digital block||lido 1%|3 mL on each side injected"][textarea cols=40 rows=1]
PROCEDURE:
[checkbox name="procedure" value="partial avulsion completed to lateral aspect of nail plate|partial avulsion completed to medical aspect of nail plate|area probed and inspected for nail fragments|ablation with phenol 30 sec x3|antibacterial ointment applied||covered with non-adherent dressing|applied bulky gauze dressing||patient tolerated procedure well|"][textarea cols=40 rows=1]

INSTRUCTED:
[checkbox name="instructed" value="wound check in 2 days|return immediately for increasing pain, swelling, redness, drainage, fever||keep wound dry||remove packing in 24 hours||daily warm soaks|daily dressing change|"][textarea cols=40 rows=1]
CONSENT:


TETANUS:


NAIL:

SURROUNDING SKIN:

REGIONAL:


PREP:

ANESTHESIA:

PROCEDURE:


INSTRUCTED:
Result - Copy and paste this output: