Short HPI Triage
cc: [text size="50"] HPI: [text size="30"] is an [text size="3"] year-old [select value="male|female"] who presents for [select value="initial visit|ongoing visit|acute visit|telephonic visit"]. [select value="Her|His"] PMH is significant for [text size="50"].[comment memo="Symptoms"]. -Symptoms started [text size="3"] [select value="hour(s)|day(s)|week(s)|month(s)|year(s)"] ago. -Patient reports these symptoms are located [text size="35"]. -Patient reports these symptoms are [select value="getting worse|getting better|the same"] since onset. -Rates it as [text size="5"]/10 in severity. -Describes the character/quality as [checkbox value="sharp|dull|burning|tingling|N/A"][text size="30"].[comment memo="Other comments on character/quality"] -Above symptom(s) [select value="do not travel/radiate|travel/radiate to"] [text size="25"]. -[select name="Associated" value="Denies any associated symptoms.|Reports these associated symptoms that started around the same time-"][conditional field="Associated" condition="(Associated).is('Reports these associated symptoms that started around the same time-')"] [text size="25"].[/conditional] -Related activities or events that occured at or right before symptoms started: [text size="80"]. -Therapies attempted: [text size="80"]. -Symptoms are improved with [text size ="50"]. -Symptoms are worsened by [text size="50"]. -Patient [select value="denies|admits to"] history of similar symptoms previously. [comment memo="Additional explanation and context:"][textarea]
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Sandbox Metrics: Structured Data Index 0.38, 28 form elements, 70 boilerplate words, 14 text boxes, 1 text areas, 1 checkboxes, 8 drop downs, 3 comments, 1 conditionals, 28 total clicks
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