Progress note

Status: [checkbox name="variable_1" value="No Change|Improvement|Setback|Deteriorating"]
Response to TX: [checkbox name="variable_2" value="Engaged|Uninterested|Cooperative|Combative"]
Suicide: [checkbox name="variable_3" value="None|Ideation|Plan|Intent"]
Danger to: [checkbox name="variable_4" value="None|Self|Others"]
Appearance:[checkbox name="variable_5" value="Appropriate|Inappropriate|Disheveled|Poor"]
Judgement: [checkbox name="variable_6" value="Excellent|Good|Fair|Poor"]
Insight: [checkbox name="variable_7" value="Full|Partial|Limited|None"]
Speech: [checkbox name="variable_8" value="Appropriate|Slurred|Rapid|Pressured|Restricted"]
Thought Content:[checkbox name="variable_9" value="Hallucinations|Delusions|Paranoid|Dissociation|Appropriate"]
Thought Process: [checkbox name="variable_10" value="Irrelevant Detail|Disorganized|Interrupted Thinking|Loose|Illogical Connections|False Beliefs|Appropriate"]
Mood:[checkbox name="variable_11" value="Depressed|Anxious|Irritable|Angry|Elevated|Euthymic|Cheerful"]
Behavior: [checkbox name="variable_12" value="Appropriate|Poor Eye Contact|Distant/Distracted|Hostile|Agitated|Overly Accommodation|Focused"]
Affect: [checkbox name="variable_13" value="Expansive|Euthymic|Constricted|Blunt|Flat|Dysphoric|Normal"]
Treatment Interventions: [checkbox name="variable_14" value="CBT|DBT|Anger Management|Roleplay|Coping Skills|Supportive Reflections|Psychoeducation|Mindfullness Training|Problem Solving Skills|Solution-Focused|Stress Management|Building Support|Crisis Intervention|Positive Psychology|Humanistic Therapy|Trauma Focused CBT|EMDR|Attachment Therapy|Systemic Family Therapy|Play or Art Therapy|Client-Centered Therapy|Existential Therapy|Communication Training|Grief Processing|Other"]
Notes from Session : [text name="variable_15" default=""]
Status:
Response to TX:
Suicide:
Danger to:
Appearance:
Judgement:
Insight:
Speech:
Thought Content:
Thought Process:
Mood:
Behavior:
Affect:
Treatment Interventions:
Notes from Session :

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.93, 15 form elements, 23 boilerplate words, 1 text boxes, 14 checkboxes, 91 total clicks
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