Chronic hpi

Note scribed by [select name="notetaker" value="Physician|Nurse Practitioner|PA|Medical Assistant|Nurse|Student"] - Adult Chronic/Followup Visit
[checkbox memo="if not already inputted" memo_size="small" name="Vitals" value="Vital signs:"][conditional field="Vitals" condition="(Vitals).is('Vital signs:')"] HR [text size="5"]; SpO2 [text size="5"]; [checkbox name="Temp" value="Temp"][/conditional][conditional field="Temp" condition="(Temp).is('Temp')"] [text size="5"] deg F; [/conditional][conditional field="Vitals" condition="(Vitals).is('Vital signs:')"][checkbox name="BP" value="BP"][/conditional][conditional field="BP" condition="(BP).is('BP')"] [text size="5"] / [text size="5"] mmHg; [/conditional][conditional field="Vitals" condition="(Vitals).is('Vital signs:')"][checkbox name="RR" value="RR"][/conditional][conditional field="RR" condition="(RR).is('RR')"] [text size="5"] breaths/min; [/conditional][conditional field="Vitals" condition="(Vitals).is('Vital signs:')"][checkbox name="HT" value="HT"][/conditional][conditional field="HT" condition="(HT).is('HT')"] [text size="5"] [select value="in|cm"]; [/conditional][conditional field="Vitals" condition="(Vitals).is('Vital signs:')"][checkbox name="WT" value="WT"][/conditional][conditional field="WT" condition="(WT).is('WT')"] [text size="5"] [select value="lbs|kg"][/conditional][conditional field="Vitals" condition="(Vitals).is('Vital signs:')"][/conditional][checkbox memo="include HPI Intro" memo_size="small" name="include_hpi_block" value="HPI"][conditional field="include_hpi_block" condition="(include_hpi_block).is('HPI')"]
[text default="The patient"] is a [text size="5"] yo [select name="Gender" value="|gentleman|lady|M|F"] presenting [select name="visit_type" value="to the office|via televideo platform|via phone call"] 
[select name="variable_1" value="for evaluation and management of|with a relevant past medical history significant for"] [checkbox name="variable_18" value="***|___A___|acute diastolic congestive heart failure (CHF)|acute kidney history (AKI)|acute midline back pain with sciatica|acute midline back pain without sciatica|acute subdural hematoma|alcohol abuse|alcohol use disorder|amphetamine abuse|anasarca|aneurysm (intracranial)|anemia|anemia due to blood loss|anemia due to chronic stage 4 renal failure|anti-phospholipid syndrome (APS)|anxiety|aortic valve stenosis|arthritis (osteoarthritis)|ascites due to cirrhosis|asthma|atrial fibrillation|avascular necrosis of the ***|avascular necrosis in bilateral hips|avascular necrosis of right humerus|avascular necrosis of left humerus|___B___|bacterial vaginosis (BV)|benzodiazepine abuse|___C___|cardiomyopathy|carotid stenosis (left)|carotid stenosis (right)|carpal tunnel syndrome (CTS)|cataracts|cataracts secondary to diabetes|cervical disk disorder|cervical radiculopathy|chronic abdominal pain|chronic anemia|chronic cough|chronic cough secondary to ACE inhibitor|chronic pain with long-term opiate medications|chronic obstructive pulmonary disease (COPD)|chronic insomnia|chronic kidney disease (CKD) secondary to type II diabetes|chronic insomnia|chronic kidney disease (CKD) secondary to type I diabetes|chronic renal allograft nephropathy|clostridium difficile infection|cocaine use|colonic polyps|colonic polyps status post removal in ***|cystocele (lateral)|cystocele (midline)|cyclic vomiting syndrome|cystic fibrosis|___D___|delirium|depression|diabetes type I|diabetes type II|diabetic nephropathy secondary to type I diabetes|diabetic nephropathy secondary to type II diabetes|diarrhea|drug seeking behavior|deep venous thrombosis (DVT)|deep venous thrombosis (DVT) of right leg|deep venous thrombosis (DVT) of left leg|diverticulitis|diverticulosis|___E___|eclampsia|emphysema|episode of syncope|episodes of syncope|episodic syncope|esophageal varices|essential hypertension|ethanol abuse|___F___|fall|___G___|gastritis|gastroesopheal reflux disease (GERD)|generalized abdominal pain|gilbert disease|___H___|heart failure with preserved ejection fractiom (HFpEF)|heart murmur|hemodialysis heroine use|herpes simplex virus(HSV)|history of atrial fibrillation|history of DVT in right leg|history of DVT in left leg|history of renal transplant|hypercholesterolemia|hyperglycemic episodes|hyperkalemia|hyperlipidemia (HLD)|hypernatremia|hyperparathyroidism|hyperparathroidism secondary to renal failure|hyperphosphotemia|hypertension (HTN)|hypertension (HTN) uncontrolled|hypoglycemic episodes|hypokalemia|hyponatremia|hypophosphatemia|___I___|incomplete bladder emptying|intracranial aneurysm|intractable back pain|___J___|___K___|kidney disease|___L___|lactic acidosis|liver disease|lung nodule seen on imaging study|___M___|major depressive disorder (MDD)|major depressive disorder (MDD) with mixed features| major depressive disorder (MDD) with psychotic features|malingering|metabolic acidosis|misscarriage in ***|___N___|nodular duodenitis|nodular duodenitis and scalloped appearing thicken small bowel|___O___|obstructive sleep apnea (OSA)|osteoarthritis|___P___| pancreatic cancer|pancreatitis|pancytopenia|panic attacks|parethesias|paroxysmal atrial fibrillation|pericardial effusion|pericardial effusions|peripheral artery disease (PAD)|personality disorder|placental insufficiency|poly-substance abuse|pre-eclampsia|pre-mature atrial contraction|primary prostatic cancer|primary prostatic cancer with metastasis|protienuria|pulmonary embolism|pulmonary hypertension|___Q___|___R___|rectocele|recurrent urinary tract infection (UTI)|retroperitoneal lymphadenopathy|___S___|scoliosis|secondary hyperparathyroidism of renal origin|shortness of breath (SOB)|sickel cell anemia|sickle cell disease|sickle cell disease with frequent admissions for pain control|sleep apnea|spontaneous bacterial peritonitis|stage 4 chronic kidney disease|stroke|stroke with residual right hemiparesis|stroke with residual left hemiparesis|subarachnoid hemorrhage (SAH)|subdural hematoma|syndrome of inappropriate antidiuretic hormone (SIADH)|systemic lupus erythematosus (SLE)|___T___|thrombocytopenia|tobacco use|type I diabetes|type II diabetes with complication|type II diabetes without complications|___U___|urinary retention|urinary retention secondary to benign prosthetic hypertrophy (BPH)|urinary tract infections (UTI)|ulnar nerve compression|___V___|venous thromboembolism (VTE)|___W___|wegner's granulomatosis|___X___|___Y___|___Z___"]. [/conditional]
[checkbox memo="#1" memo_size="small" name="chr1" value="-Chronic Condition-"][conditional field="chr1" condition="(chr1).is('-Chronic Condition-')"][comment memo="-------------BEGIN CONDITION 1-------------"] [text memo="freetext or select one" memo_size="small" size="70"][select value="|Hypertension|Mixed Hyperlipidemia|Type 2 Diabetes|Type 1 Diabetes|Thyroid Atrophy|Obesity|Migraines|Chronic Rhinitis|Cardiovasc Disease/MI|CHF|Asthma|COPD|ILD|IBS|GERD|Peptic Ulcer Disease|Constipation|IBD|CKD|BPH|Urinary Incontinence|Kidney Stones|Dysmenorrhea|PCOS|Metrorrhagia|Recurrent BV|Recurrent Candidiasis|Pelvic Organ Prolapse|Menopausal Sx|Acne|Seborrheic Dermatitis|Rosacea|Warts|Eczema|Actinic Keratosis|Seborrheic Keratosis|Pseudofolliculitis Barbae"]
 -Patient reports that the condition is [select name="control1" value="well controlled|not well controlled|stable|unchanged from last visit|improved from last visit|worse than at last visit"]
 -Currently,[select name="symptoms1" value="the patient notes there are no symptoms.|symptoms are present including"][/conditional][conditional field="symptoms1" condition="(symptoms1).is('symptoms are present including')"] [checkbox value="pain|fatigue|shortness of breath|palpitations|nausea|vomiting|abdominal pain|urinary symptoms"] [text size=60][/conditional][conditional field="chr1" condition="(chr1).is('-Chronic Condition-')"][checkbox name="currenttx1" memo="current treatment" value=""][/conditional][conditional field="currenttx1" condition="(currenttx1).is('')"]
-Current treatments include [select name="medtx1" value="no medications.|medications including "][/conditional][conditional field="medtx1" condition="(medtx1).is('medications including ')"][text size="80"].[select value="|Patient notes medication is working.|Patient notes medication does not seem to be working."][/conditional][conditional field="currenttx1" condition="(currenttx1).is('')"][select name="othertx1" value="No other treatments are noted.|Additional treatments include "][/conditional][conditional field="othertx1" condition="(othertx1).is('Additional treatments include ')"] [text size="80"]. [/conditional][conditional field="chr1" condition="(chr1).is('-Chronic Condition-')"][checkbox name="prevtx1" memo="previous treatments" value=""][/conditional][conditional field="prevtx1" condition="(prevtx1).is('')"] 
-Previous treatments include 
[checkbox name="ptx11" value="  -#1 - "][/conditional][conditional field="ptx11" condition="(ptx11).is('  -#1 - ')"][text size="60"], reason discontinued - [checkbox value="intolerable side effects|no improvement"][text memo="other reason" memo_size="small" size="60"]
[/conditional][conditional field="prevtx1" condition="(prevtx1).is('')"][checkbox name="ptx12" value="  -#2 - "][/conditional][conditional field="ptx12" condition="(ptx12).is('  -#2 - ')"][text size="60"], reason discontinued - [checkbox value="intolerable side effects|no improvement"][text memo="other reason" memo_size="small" size="60"]
[/conditional][conditional field="prevtx1" condition="(prevtx1).is('')"][checkbox name="ptx13" value="  -#3 - "][/conditional][conditional field="ptx13" condition="(ptx13).is('  -#3 - ')"][text size="60"], reason discontinued - [checkbox value="intolerable side effects|no improvement"][text memo="other reason" memo_size="small" size="60"]
[/conditional][conditional field="chr1" condition="(chr1).is('-Chronic Condition-')"][checkbox memo="patient requests diagnostic or lab tests" name="dxreq1" value=""][/conditional][conditional field="dxreq1" condition="(dxreq1).is('')"]
 -Patient requests diagnostic testing including [text size="80"][/conditional][conditional field="chr1" condition="(chr1).is('-Chronic Condition-')"][checkbox memo="Other specialists comanage the condition" name="OtherSpecs1" value=""][/conditional][conditional field="OtherSpecs1" condition="(OtherSpecs1).is('')"]
 -Other specialists comanaging - [textarea memo="name & specialty & how recently seen" memo_size="small"][/conditional][conditional field="chr1" condition="(chr1).is('-Chronic Condition-')"][comment memo="other details"][textarea default=""]
-Pt satisfied with current management: [checkbox name="Satisfied1" value="Yes|No"][/conditional][conditional field="Satisfied1" condition="(Satisfied1).is('No')"]--[text memo="details" size=60][/conditional][conditional field="chr1" condition="(chr1).is('-Chronic Condition-')"]
[comment memo="--------------END CONDITION 1--------------"][/conditional][checkbox memo="#2" memo_size="small" name="chr2" value="-Chronic Condition-"][conditional field="chr2" condition="(chr2).is('-Chronic Condition-')"][comment memo="-------------BEGIN CONDITION 2-------------"] [text memo="freetext or select one" memo_size="small" size="70"][select value="|Hypertension|Mixed Hyperlipidemia|Type 2 Diabetes|Type 1 Diabetes|Thyroid Atrophy|Obesity|Migraines|Chronic Rhinitis|Cardiovasc Disease/MI|CHF|Asthma|COPD|ILD|IBS|GERD|Peptic Ulcer Disease|Constipation|IBD|CKD|BPH|Urinary Incontinence|Kidney Stones|Dysmenorrhea|PCOS|Metrorrhagia|Recurrent BV|Recurrent Candidiasis|Pelvic Organ Prolapse|Menopausal Sx|Acne|Seborrheic Dermatitis|Rosacea|Warts|Eczema|Actinic Keratosis|Seborrheic Keratosis|Pseudofolliculitis Barbae"]
 -Patient reports that the condition is [select name="control2" value="well controlled|not well controlled|stable|unchanged from last visit|improved from last visit|worse than at last visit"]
 -Currently,[select name="symptoms2" value="the patient notes there are no symptoms.|symptoms are present including"][/conditional][conditional field="symptoms2" condition="(symptoms2).is('symptoms are present including')"] [checkbox value="pain|fatigue|shortness of breath|palpitations|nausea|vomiting|abdominal pain|urinary symptoms"] [text size=60][/conditional][conditional field="chr2" condition="(chr2).is('-Chronic Condition-')"][checkbox name="currenttx2" memo="current treatment" value=""][/conditional][conditional field="currenttx2" condition="(currenttx2).is('')"]
-Current treatments include [select name="medtx2" value="no medications.|medications including "][/conditional][conditional field="medtx2" condition="(medtx2).is('medications including ')"][text size="80"].[select value="|Patient notes medication is working.|Patient notes medication does not seem to be working."][/conditional][conditional field="currenttx2" condition="(currenttx2).is('')"][select name="othertx2" value="No other treatments are noted.|Additional treatments include "][/conditional][conditional field="othertx2" condition="(othertx2).is('Additional treatments include ')"] [text size="80"]. [/conditional][conditional field="chr2" condition="(chr2).is('-Chronic Condition-')"][checkbox name="prevtx2" memo="previous treatments" value=""][/conditional][conditional field="prevtx2" condition="(prevtx2).is('')"] 
-Previous treatments include 
[checkbox name="ptx21" value="  -#1 - "][/conditional][conditional field="ptx21" condition="(ptx21).is('  -#1 - ')"][text size="60"], reason discontinued - [checkbox value="intolerable side effects|no improvement"][text memo="other reason" memo_size="small" size="60"]
[/conditional][conditional field="prevtx2" condition="(prevtx2).is('')"][checkbox name="ptx22" value="  -#2 - "][/conditional][conditional field="ptx22" condition="(ptx22).is('  -#2 - ')"][text size="60"], reason discontinued - [checkbox value="intolerable side effects|no improvement"][text memo="other reason" memo_size="small" size="60"]
[/conditional][conditional field="prevtx2" condition="(prevtx2).is('')"][checkbox name="ptx23" value="  -#3 - "][/conditional][conditional field="ptx23" condition="(ptx23).is('  -#3 - ')"][text size="60"], reason discontinued - [checkbox value="intolerable side effects|no improvement"][text memo="other reason" memo_size="small" size="60"]
[/conditional][conditional field="chr2" condition="(chr2).is('-Chronic Condition-')"][checkbox memo="patient requests diagnostic or lab tests" name="dxreq2" value=""][/conditional][conditional field="dxreq2" condition="(dxreq2).is('')"]
 -Patient requests diagnostic testing including [text size="80"][/conditional][conditional field="chr2" condition="(chr2).is('-Chronic Condition-')"][checkbox memo="Other specialists comanage the condition" name="OtherSpecs2" value=""][/conditional][conditional field="OtherSpecs2" condition="(OtherSpecs2).is('')"]
 -Other specialists comanaging - [textarea memo="name & specialty & how recently seen" memo_size="small"][/conditional][conditional field="chr2" condition="(chr2).is('-Chronic Condition-')"][comment memo="other details"][textarea default=""]
-Pt satisfied with current management: [checkbox name="Satisfied2" value="Yes|No"][/conditional][conditional field="Satisfied2" condition="(Satisfied2).is('No')"]--[text memo="details" size=60][/conditional][conditional field="chr2" condition="(chr2).is('-Chronic Condition-')"]
[comment memo="--------------END CONDITION 2--------------"][/conditional][checkbox memo="#3" memo_size="small" name="chr3" value="-Chronic Condition-"][conditional field="chr3" condition="(chr3).is('-Chronic Condition-')"][comment memo="-------------BEGIN CONDITION 3-------------"] [text memo="freetext or select one" memo_size="small" size="70"][select value="|Hypertension|Mixed Hyperlipidemia|Type 2 Diabetes|Type 1 Diabetes|Thyroid Atrophy|Obesity|Migraines|Chronic Rhinitis|Cardiovasc Disease/MI|CHF|Asthma|COPD|ILD|IBS|GERD|Peptic Ulcer Disease|Constipation|IBD|CKD|BPH|Urinary Incontinence|Kidney Stones|Dysmenorrhea|PCOS|Metrorrhagia|Recurrent BV|Recurrent Candidiasis|Pelvic Organ Prolapse|Menopausal Sx|Acne|Seborrheic Dermatitis|Rosacea|Warts|Eczema|Actinic Keratosis|Seborrheic Keratosis|Pseudofolliculitis Barbae"]
 -Patient reports that the condition is [select name="control3" value="well controlled|not well controlled|stable|unchanged from last visit|improved from last visit|worse than at last visit"]
 -Currently,[select name="symptoms3" value="the patient notes there are no symptoms.|symptoms are present including"][/conditional][conditional field="symptoms3" condition="(symptoms3).is('symptoms are present including')"] [checkbox value="pain|fatigue|shortness of breath|palpitations|nausea|vomiting|abdominal pain|urinary symptoms"] [text size=60][/conditional][conditional field="chr3" condition="(chr3).is('-Chronic Condition-')"][checkbox name="currenttx3" memo="current treatment" value=""][/conditional][conditional field="currenttx3" condition="(currenttx3).is('')"]
-Current treatments include [select name="medtx3" value="no medications.|medications including "][/conditional][conditional field="medtx3" condition="(medtx3).is('medications including ')"][text size="80"].[select value="|Patient notes medication is working.|Patient notes medication does not seem to be working."][/conditional][conditional field="currenttx3" condition="(currenttx3).is('')"][select name="othertx3" value="No other treatments are noted.|Additional treatments include "][/conditional][conditional field="othertx3" condition="(othertx3).is('Additional treatments include ')"] [text size="80"]. [/conditional][conditional field="chr3" condition="(chr3).is('-Chronic Condition-')"][checkbox name="prevtx3" memo="previous treatments" value=""][/conditional][conditional field="prevtx3" condition="(prevtx3).is('')"] 
-Previous treatments include 
[checkbox name="ptx31" value="  -#1 - "][/conditional][conditional field="ptx31" condition="(ptx31).is('  -#1 - ')"][text size="60"], reason discontinued - [checkbox value="intolerable side effects|no improvement"][text memo="other reason" memo_size="small" size="60"]
[/conditional][conditional field="prevtx3" condition="(prevtx3).is('')"][checkbox name="ptx32" value="  -#2 - "][/conditional][conditional field="ptx32" condition="(ptx32).is('  -#2 - ')"][text size="60"], reason discontinued - [checkbox value="intolerable side effects|no improvement"][text memo="other reason" memo_size="small" size="60"]
[/conditional][conditional field="prevtx3" condition="(prevtx3).is('')"][checkbox name="ptx33" value="  -#3 - "][/conditional][conditional field="ptx33" condition="(ptx33).is('  -#3 - ')"][text size="60"], reason discontinued - [checkbox value="intolerable side effects|no improvement"][text memo="other reason" memo_size="small" size="60"]
[/conditional][conditional field="chr3" condition="(chr3).is('-Chronic Condition-')"][checkbox memo="patient requests diagnostic or lab tests" name="dxreq3" value=""][/conditional][conditional field="dxreq3" condition="(dxreq3).is('')"]
 -Patient requests diagnostic testing including [text size="80"][/conditional][conditional field="chr3" condition="(chr3).is('-Chronic Condition-')"][checkbox memo="Other specialists comanage the condition" name="OtherSpecs3" value=""][/conditional][conditional field="OtherSpecs3" condition="(OtherSpecs3).is('')"]
 -Other specialists comanaging - [textarea memo="name & specialty & how recently seen" memo_size="small"][/conditional][conditional field="chr3" condition="(chr3).is('-Chronic Condition-')"][comment memo="other details"][textarea default=""]
-Pt satisfied with current management: [checkbox name="Satisfied3" value="Yes|No"][/conditional][conditional field="Satisfied3" condition="(Satisfied3).is('No')"]--[text memo="details" size=60][/conditional][conditional field="chr3" condition="(chr3).is('-Chronic Condition-')"]
[comment memo="--------------END CONDITION 3--------------"][/conditional][checkbox memo="#4" memo_size="small" name="chr4" value="-Chronic Condition-"][conditional field="chr4" condition="(chr4).is('-Chronic Condition-')"][comment memo="-------------BEGIN CONDITION 4-------------"] [text memo="freetext or select one" memo_size="small" size="70"][select value="|Hypertension|Mixed Hyperlipidemia|Type 2 Diabetes|Type 1 Diabetes|Thyroid Atrophy|Obesity|Migraines|Chronic Rhinitis|Cardiovasc Disease/MI|CHF|Asthma|COPD|ILD|IBS|GERD|Peptic Ulcer Disease|Constipation|IBD|CKD|BPH|Urinary Incontinence|Kidney Stones|Dysmenorrhea|PCOS|Metrorrhagia|Recurrent BV|Recurrent Candidiasis|Pelvic Organ Prolapse|Menopausal Sx|Acne|Seborrheic Dermatitis|Rosacea|Warts|Eczema|Actinic Keratosis|Seborrheic Keratosis|Pseudofolliculitis Barbae"]
 -Patient reports that the condition is [select name="control4" value="well controlled|not well controlled|stable|unchanged from last visit|improved from last visit|worse than at last visit"]
 -Currently,[select name="symptoms4" value="the patient notes there are no symptoms.|symptoms are present including"][/conditional][conditional field="symptoms4" condition="(symptoms4).is('symptoms are present including')"] [checkbox value="pain|fatigue|shortness of breath|palpitations|nausea|vomiting|abdominal pain|urinary symptoms"] [text size=60][/conditional][conditional field="chr4" condition="(chr4).is('-Chronic Condition-')"][checkbox name="currenttx4" memo="current treatment" value=""][/conditional][conditional field="currenttx4" condition="(currenttx4).is('')"]
-Current treatments include [select name="medtx4" value="no medications.|medications including "][/conditional][conditional field="medtx4" condition="(medtx4).is('medications including ')"][text size="80"].[select value="|Patient notes medication is working.|Patient notes medication does not seem to be working."][/conditional][conditional field="currenttx4" condition="(currenttx4).is('')"][select name="othertx4" value="No other treatments are noted.|Additional treatments include "][/conditional][conditional field="othertx4" condition="(othertx4).is('Additional treatments include ')"] [text size="80"]. [/conditional][conditional field="chr4" condition="(chr4).is('-Chronic Condition-')"][checkbox name="prevtx4" memo="previous treatments" value=""][/conditional][conditional field="prevtx4" condition="(prevtx4).is('')"] 
-Previous treatments include 
[checkbox name="ptx41" value="  -#1 - "][/conditional][conditional field="ptx41" condition="(ptx41).is('  -#1 - ')"][text size="60"], reason discontinued - [checkbox value="intolerable side effects|no improvement"][text memo="other reason" memo_size="small" size="60"]
[/conditional][conditional field="prevtx4" condition="(prevtx4).is('')"][checkbox name="ptx42" value="  -#2 - "][/conditional][conditional field="ptx42" condition="(ptx42).is('  -#2 - ')"][text size="60"], reason discontinued - [checkbox value="intolerable side effects|no improvement"][text memo="other reason" memo_size="small" size="60"]
[/conditional][conditional field="prevtx4" condition="(prevtx4).is('')"][checkbox name="ptx43" value="  -#3 - "][/conditional][conditional field="ptx43" condition="(ptx43).is('  -#3 - ')"][text size="60"], reason discontinued - [checkbox value="intolerable side effects|no improvement"][text memo="other reason" memo_size="small" size="60"]
[/conditional][conditional field="chr4" condition="(chr4).is('-Chronic Condition-')"][checkbox memo="patient requests diagnostic or lab tests" name="dxreq4" value=""][/conditional][conditional field="dxreq4" condition="(dxreq4).is('')"]
 -Patient requests diagnostic testing including [text size="80"][/conditional][conditional field="chr4" condition="(chr4).is('-Chronic Condition-')"][checkbox memo="Other specialists comanage the condition" name="OtherSpecs4" value=""][/conditional][conditional field="OtherSpecs4" condition="(OtherSpecs4).is('')"]
 -Other specialists comanaging - [textarea memo="name & specialty & how recently seen" memo_size="small"][/conditional][conditional field="chr4" condition="(chr4).is('-Chronic Condition-')"][comment memo="other details"][textarea default=""]
-Pt satisfied with current management: [checkbox name="Satisfied4" value="Yes|No"][/conditional][conditional field="Satisfied4" condition="(Satisfied4).is('No')"]--[text memo="details" size=60][/conditional][conditional field="chr4" condition="(chr4).is('-Chronic Condition-')"]
[comment memo="--------------END CONDITION 4--------------"][/conditional][checkbox memo="#5" memo_size="small" name="chr5" value="-Chronic Condition-"][conditional field="chr5" condition="(chr5).is('-Chronic Condition-')"][comment memo="-------------BEGIN CONDITION 5-------------"] [text memo="freetext or select one" memo_size="small" size="70"][select value="|Hypertension|Mixed Hyperlipidemia|Type 2 Diabetes|Type 1 Diabetes|Thyroid Atrophy|Obesity|Migraines|Chronic Rhinitis|Cardiovasc Disease/MI|CHF|Asthma|COPD|ILD|IBS|GERD|Peptic Ulcer Disease|Constipation|IBD|CKD|BPH|Urinary Incontinence|Kidney Stones|Dysmenorrhea|PCOS|Metrorrhagia|Recurrent BV|Recurrent Candidiasis|Pelvic Organ Prolapse|Menopausal Sx|Acne|Seborrheic Dermatitis|Rosacea|Warts|Eczema|Actinic Keratosis|Seborrheic Keratosis|Pseudofolliculitis Barbae"]
 -Patient reports that the condition is [select name="control5" value="well controlled|not well controlled|stable|unchanged from last visit|improved from last visit|worse than at last visit"]
 -Currently,[select name="symptoms5" value="the patient notes there are no symptoms.|symptoms are present including"][/conditional][conditional field="symptoms5" condition="(symptoms5).is('symptoms are present including')"] [checkbox value="pain|fatigue|shortness of breath|palpitations|nausea|vomiting|abdominal pain|urinary symptoms"] [text size=60][/conditional][conditional field="chr5" condition="(chr5).is('-Chronic Condition-')"][checkbox name="currenttx5" memo="current treatment" value=""][/conditional][conditional field="currenttx5" condition="(currenttx5).is('')"]
-Current treatments include [select name="medtx5" value="no medications.|medications including "][/conditional][conditional field="medtx5" condition="(medtx5).is('medications including ')"][text size="80"].[select value="|Patient notes medication is working.|Patient notes medication does not seem to be working."][/conditional][conditional field="currenttx5" condition="(currenttx5).is('')"][select name="othertx5" value="No other treatments are noted.|Additional treatments include "][/conditional][conditional field="othertx5" condition="(othertx5).is('Additional treatments include ')"] [text size="80"]. [/conditional][conditional field="chr5" condition="(chr5).is('-Chronic Condition-')"][checkbox name="prevtx5" memo="previous treatments" value=""][/conditional][conditional field="prevtx5" condition="(prevtx5).is('')"] 
-Previous treatments include 
[checkbox name="ptx51" value="  -#1 - "][/conditional][conditional field="ptx51" condition="(ptx51).is('  -#1 - ')"][text size="60"], reason discontinued - [checkbox value="intolerable side effects|no improvement"][text memo="other reason" memo_size="small" size="60"]
[/conditional][conditional field="prevtx5" condition="(prevtx5).is('')"][checkbox name="ptx52" value="  -#2 - "][/conditional][conditional field="ptx52" condition="(ptx52).is('  -#2 - ')"][text size="60"], reason discontinued - [checkbox value="intolerable side effects|no improvement"][text memo="other reason" memo_size="small" size="60"]
[/conditional][conditional field="prevtx5" condition="(prevtx5).is('')"][checkbox name="ptx53" value="  -#3 - "][/conditional][conditional field="ptx53" condition="(ptx53).is('  -#3 - ')"][text size="60"], reason discontinued - [checkbox value="intolerable side effects|no improvement"][text memo="other reason" memo_size="small" size="60"]
[/conditional][conditional field="chr5" condition="(chr5).is('-Chronic Condition-')"][checkbox memo="patient requests diagnostic or lab tests" name="dxreq5" value=""][/conditional][conditional field="dxreq5" condition="(dxreq5).is('')"]
 -Patient requests diagnostic testing including [text size="80"][/conditional][conditional field="chr5" condition="(chr5).is('-Chronic Condition-')"][checkbox memo="Other specialists comanage the condition" name="OtherSpecs5" value=""][/conditional][conditional field="OtherSpecs5" condition="(OtherSpecs5).is('')"]
 -Other specialists comanaging - [textarea memo="name & specialty & how recently seen" memo_size="small"][/conditional][conditional field="chr5" condition="(chr5).is('-Chronic Condition-')"][comment memo="other details"][textarea default=""]
-Pt satisfied with current management: [checkbox name="Satisfied5" value="Yes|No"][/conditional][conditional field="Satisfied5" condition="(Satisfied5).is('No')"]--[text memo="details" size=60][/conditional][conditional field="chr5" condition="(chr5).is('-Chronic Condition-')"]
[comment memo="--------------END CONDITION 5--------------"][/conditional][checkbox memo="#6" memo_size="small" name="chr6" value="-Chronic Condition-"][conditional field="chr6" condition="(chr6).is('-Chronic Condition-')"][comment memo="-------------BEGIN CONDITION 6-------------"] [text memo="freetext or select one" memo_size="small" size="70"][select value="|Hypertension|Mixed Hyperlipidemia|Type 2 Diabetes|Type 1 Diabetes|Thyroid Atrophy|Obesity|Migraines|Chronic Rhinitis|Cardiovasc Disease/MI|CHF|Asthma|COPD|ILD|IBS|GERD|Peptic Ulcer Disease|Constipation|IBD|CKD|BPH|Urinary Incontinence|Kidney Stones|Dysmenorrhea|PCOS|Metrorrhagia|Recurrent BV|Recurrent Candidiasis|Pelvic Organ Prolapse|Menopausal Sx|Acne|Seborrheic Dermatitis|Rosacea|Warts|Eczema|Actinic Keratosis|Seborrheic Keratosis|Pseudofolliculitis Barbae"]
 -Patient reports that the condition is [select name="control6" value="well controlled|not well controlled|stable|unchanged from last visit|improved from last visit|worse than at last visit"]
 -Currently,[select name="symptoms6" value="the patient notes there are no symptoms.|symptoms are present including"][/conditional][conditional field="symptoms6" condition="(symptoms6).is('symptoms are present including')"] [checkbox value="pain|fatigue|shortness of breath|palpitations|nausea|vomiting|abdominal pain|urinary symptoms"] [text size=60][/conditional][conditional field="chr6" condition="(chr6).is('-Chronic Condition-')"][checkbox name="currenttx6" memo="current treatment" value=""][/conditional][conditional field="currenttx6" condition="(currenttx6).is('')"]
-Current treatments include [select name="medtx6" value="no medications.|medications including "][/conditional][conditional field="medtx6" condition="(medtx6).is('medications including ')"][text size="80"].[select value="|Patient notes medication is working.|Patient notes medication does not seem to be working."][/conditional][conditional field="currenttx6" condition="(currenttx6).is('')"][select name="othertx6" value="No other treatments are noted.|Additional treatments include "][/conditional][conditional field="othertx6" condition="(othertx6).is('Additional treatments include ')"] [text size="80"]. [/conditional][conditional field="chr6" condition="(chr6).is('-Chronic Condition-')"][checkbox name="prevtx6" memo="previous treatments" value=""][/conditional][conditional field="prevtx6" condition="(prevtx6).is('')"] 
-Previous treatments include 
[checkbox name="ptx61" value="  -#1 - "][/conditional][conditional field="ptx61" condition="(ptx61).is('  -#1 - ')"][text size="60"], reason discontinued - [checkbox value="intolerable side effects|no improvement"][text memo="other reason" memo_size="small" size="60"]
[/conditional][conditional field="prevtx6" condition="(prevtx6).is('')"][checkbox name="ptx62" value="  -#2 - "][/conditional][conditional field="ptx62" condition="(ptx62).is('  -#2 - ')"][text size="60"], reason discontinued - [checkbox value="intolerable side effects|no improvement"][text memo="other reason" memo_size="small" size="60"]
[/conditional][conditional field="prevtx6" condition="(prevtx6).is('')"][checkbox name="ptx63" value="  -#3 - "][/conditional][conditional field="ptx63" condition="(ptx63).is('  -#3 - ')"][text size="60"], reason discontinued - [checkbox value="intolerable side effects|no improvement"][text memo="other reason" memo_size="small" size="60"]
[/conditional][conditional field="chr6" condition="(chr6).is('-Chronic Condition-')"][checkbox memo="patient requests diagnostic or lab tests" name="dxreq6" value=""][/conditional][conditional field="dxreq6" condition="(dxreq6).is('')"]
 -Patient requests diagnostic testing including [text size="80"][/conditional][conditional field="chr6" condition="(chr6).is('-Chronic Condition-')"][checkbox memo="Other specialists comanage the condition" name="OtherSpecs6" value=""][/conditional][conditional field="OtherSpecs6" condition="(OtherSpecs6).is('')"]
 -Other specialists comanaging - [textarea memo="name & specialty & how recently seen" memo_size="small"][/conditional][conditional field="chr6" condition="(chr6).is('-Chronic Condition-')"][comment memo="other details"][textarea default=""]
-Pt satisfied with current management: [checkbox name="Satisfied6" value="Yes|No"][/conditional][conditional field="Satisfied6" condition="(Satisfied6).is('No')"]--[text memo="details" size=60][/conditional][conditional field="chr6" condition="(chr6).is('-Chronic Condition-')"]
[comment memo="--------------END CONDITION 6--------------"][/conditional]
[checkbox name="lifestyle" memo="Current Lifestyle/Therapeutic Lifestyle Choices" value=""]
[conditional field="lifestyle" condition="(lifestyle).is('')"]Current Lifestyle/Therapeutic Lifestyle Choices
-Diet - [checkbox value="N/A|none|DASH diet|diabetic Diet|weight reduction diet|standard american diet"][text size="80"]
  -Physical activity - [checkbox value="N/A|none"][text size="80"]
  -Medications - [checkbox value="N/A|none"][text size="80"][/conditional][checkbox name="lifestyle_mod" memo="lifestyle risk factor modification" value=""][conditional field="lifestyle_mod" condition="(lifestyle_mod).is('')"]-Lifestyle risk factor modification/optimization -
 -If smoking/chewing/vaping, patient indicates willingness to discuss quitting? [checkbox value="N/A|Yes|No"]
 -If consuming alcohol in significant amts daily, patient indicates willingness to discuss cutting back? [checkbox value="N/A|Yes|No"]
 -If overweight/obese, patient indicates willingness to discuss? [checkbox value="N/A|Yes|No"]
[/conditional]
-Questions/concerns of patient about these above conditions: [checkbox value="none"][textarea rows="4"]