OPQRST

Occupation: [text]
Sports: [text]
Involved Side:[text]
Date of Injury:[text] 
History of Present Illness:
[textarea]
Pain Severity:[text]   
Pain location: [text] 
Pain at rest: [text] 
Pain with activity:[text] 
Ameliorating Factors:[text] 
Exacerbating factors: [text]
Pain Duration:[text]
Pain night:[text]
Previous treatment:[text]
Occupation:
Sports:
Involved Side:
Date of Injury:
History of Present Illness:

Pain Severity:
Pain location:
Pain at rest:
Pain with activity:
Ameliorating Factors:
Exacerbating factors:
Pain Duration:
Pain night:
Previous treatment:

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0, 14 form elements, 31 boilerplate words, 13 text boxes, 1 text areas, 14 total clicks
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