Progress Note

Identifying Information:
[text name="name" memo="Client's name" size="22"]is a [text memo="age" size="2"]-year-old,
[checkbox value="single|married|in rlsp|divorced|"widowed"] 
[select value="Choose one|lives with their significant other |lives with their family |lives alone |is homeless|lives with their parents |lives with their children |lives with a roommate |renting a room |"]
LOCATION:[text size="20"] CITY: [text memo= size="20"]. [select value=[text memo= 9="20"]. [textarea memo="Additional presentation information" rows="5"]History of Presenting Illness:
[var name="name"] [select value="presents in this initial outpatient appointment| "][select value=" alone| with family| with significant other| with DHHS worker| with case manager|"][text memo="names" size="20"][select value=" for evaluation and management of the chief complaint of | due to reports of |"][text memo="presenting problem" size="20"].[checkbox name="depression" memo="depression" value=""][checkbox name="anxiety" memo="anxiety" value=""][checkbox name="sleep" memo="sleep" value=""][checkbox name="mood" memo="mood" value=""][checkbox name="ptsd" memo="ptsd" value=""][checkbox name="adhd" memo="adhd" value=""][checkbox name="autism" memo="autism" value=""]