sick call final # 1

[select name="variable_50" value="INITIAL PSYCHIATRIC CONSULT|3 MONTH PSYCHIATRIC MEDICATION REVIEW|PSYCHIATRIC MEDICATION REVIEW PER REQUEST OF INMATE|PSYCHIATRIC MEDICATION REVIEW PER REQUEST OF MHC|PSYCHIATRIC MEDICATION RENEWAL NEEDED|MH EVALUATION|MHC ROUNTINE F/U|MHC F/U PER RFI|MHC F/U PER MEDICAL|MHC F/U PER SECURITY STAFF|SUICIDE RISK ASSESSMENT|SP F/U|SP 24H POST RELEASE F/U"]. DX: [checkbox name="variable_8888" value="|history of suicidal behavior|acute stress disorder|history of self injurious behavior|adustment disorder with disturbance of emotions and conduct|major depressive disorder recurrent moderate|bipolar disorder|schizophrenia|schizoaffective bipolar type|schizoaffective depressive type|unspecified depressive disorder|unspecified anxiety disorder|unspecified schizophrenia spectrum and other psychotic disorder|unspecified mood disorder|unpspecified bipolar disorder|Unspecified trauma- and stressor-related disorder|adjustment disorder|borderline personality disorder|neurocognitive disorder"]   RX: [checkbox name="variable_" v3354364 value="medication recommended but inmate refused|medication recommended but inmate discontinued|no medication recommended at this time|Alprazolam (Xanax)Amphetamine (Adderall)|Aripiprazole(Abilify)|Asenapine (Saphris)|Atomoxetine (Strattera)|Brexanolone (Zulresso)|Brexpiprazole (Rexulti)|Buprenorphine (Sublocade)|Buprenorphine/Naloxone (Suboxone)|Bupropion (Wellbutrin)|Buspirone (BuSpar)|Cariprazine (Vraylar)|Citalopram (Celexa)|Clonazepam (Klonopin)|Clonidine (Kapvay and Catapres)|Clozapine (Clozaril and FazaClo)|Desvenlafaxine (Pristiq)|Depakote (divalproex sodium)|Deutetrabenazine (Austedo)|Diazepam (Valium)|Disulfiram (Antabuse)|Duloxetine (Cymbalta)|Escitalopram (Lexapro)|Esketamine (Spravato)|Fluoxetine (Prozac)|Fluphenazine (Prolixin)| Fluvoxamine (Luvox)|Guanfacine (Intuniv)|Haloperidol (Haldol)| Hydroxyzine (Vistaril, Atarax)| Iloperidone (Fanapt)|Lamotrigine (Lamictal)| Levomilnacipran (Fetzima)|Lithium|Lofexidine (Lucemyra)| Lorazepam (Ativan)|Loxapine (Loxitane)| Lumateperone (Caplyta)|Lurasidone (Latuda)|Methylphenidate or Dexmethylphenidate (Concerta, Ritalin and others)|Mirtazapine (Remeron)|Naloxone (Narcan, Evzio)|Naltrexone (ReVia)|Olanzapine (Zyprexa)|Olanzapine/Samidorphan (Lybalvi)|Oxcarbazepine| Paliperidone (Invega)|Paroxetine (Paxil)|Phenelzine (Nardil)|Pimavanserin (Nuplazid)|Quetiapine (Seroquel)|Risperidone (Risperdal)|Sertraline (Zoloft)|Topiramate (Topamax)|Tranylcypromine (Parnate)|Valbenazine (Ingrezza)|Valproate (Depakote)| Venlafaxine (Effexor)|Vilazodone (Viibryd)|Vortioxetine (Trintellix)| Ziprasidone (Geodon)"]   [select name="variable_dd" value="LAST VISIT:|PRESCRIPTION EXPIRES ON:"] [date name="variable_" default=484848"08-05-2023"] NOTES: [textarea name="variable_1" default=""]
. DX: RX: NOTES:

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.83, 6 form elements, 3 boilerplate words, 1 text areas, 1 dates, 2 checkboxes, 2 drop downs, 86 total clicks
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