Subjective/History Elements
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[checkbox name="MasterROS" memo="ROS" memo_size="large" value=""][conditional field="MasterROS" condition="(MasterROS).is('')"]Review of Systems
[/conditional][conditional field="MasterROS" condition="(MasterROS).is('')"][checkbox memo="constitutional" name="constitutional" value=""][/conditional][conditional field="constitutional" condition="(constitutional).is('')"]constitutional symptoms: [select value="denies|endorses"] fever, [select value="denies|endorses"] weight loss, [select value="denies|endorses"] extreme fatigue. [textarea memo="explanation of abnormals if needed" memo_size="small" memo_color="orange" rows="2"]
[/conditional][conditional field="MasterROS" condition="(MasterROS).is('')"][checkbox memo="eyes" name="eyes" value=""][/conditional][conditional field="eyes" condition="(eyes).is('')"]eyes: [select value="denies|endorses"] double vision, [select value="denies|endorses"] sudden loss of vision. [textarea memo="explanation of abnormals if needed" memo_size="small" memo_color="orange" rows="2"]
[/conditional][conditional field="MasterROS" condition="(MasterROS).is('')"][checkbox memo="HEENT" name="HEENT" value=""][/conditional][conditional field="HEENT" condition="(HEENT).is('')"]ears, nose, mouth, throat: [select value="denies|endorses"] sore throat, [select value="denies|endorses"] runny nose, [select value="denies|endorses"] ear pain. [textarea memo="explanation of abnormals if needed" memo_size="small" memo_color="orange" rows="2"]
[/conditional][conditional field="MasterROS" condition="(MasterROS).is('')"][checkbox memo="cardiovascular" name="cardiovascular" value=""][/conditional][conditional field="cardiovascular" condition="(cardiovascular).is('')"]cardiovascular: [select value="denies|endorses"] chest pain, [select value="denies|endorses"] palpitations. [textarea memo="explanation of abnormals if needed" memo_size="small" memo_color="orange" rows="2"]
[/conditional][conditional field="MasterROS" condition="(MasterROS).is('')"][checkbox memo="respiratory" name="respiratory" value=""][/conditional][conditional field="respiratory" condition="(respiratory).is('')"]respiratory: [select value="denies|endorses"] cough, [select value="denies|endorses"] wheezing, [select value="denies|endorses"] shortness of breath. [textarea memo="explanation of abnormals if needed" memo_size="small" memo_color="orange" rows="2"]
[/conditional][conditional field="MasterROS" condition="(MasterROS).is('')"][checkbox memo="gastrointestinal" name="gastrointestinal" value=""][/conditional][conditional field="gastrointestinal" condition="(gastrointestinal).is('')"]gastrointestinal: [select value="denies|endorses"] nausea, [select value="denies|endorses"] vomiting, [select value="denies|endorses"] abdominal pain, [select value="denies|endorses"] constipation, [select value="denies|endorses"] diarrhea, [select value="denies|endorses"] blood in stools. [textarea memo="explanation of abnormals if needed" memo_size="small" memo_color="orange" rows="2"]
[/conditional][conditional field="MasterROS" condition="(MasterROS).is('')"][checkbox memo="genitourinary" name="genitourinary" value=""][/conditional][conditional field="genitourinary" condition="(genitourinary).is('')"]genitourinary: [select value="denies|endorses"] urinary frequency, [select value="denies|endorses"] urinary urgency, [select value="denies|endorses"] pain with voiding, [select value="denies|endorses"] penile discharge, [select value="denies|endorses"] vaginal discharge, [select value="denies|endorses"] painful intercourse. [textarea memo="explanation of abnormals if needed" memo_size="small" memo_color="orange" rows="2"]
[/conditional][conditional field="MasterROS" condition="(MasterROS).is('')"][checkbox memo="skin" name="skin" value=""][/conditional][conditional field="skin" condition="(skin).is('')"]skin: [select value="denies|endorses"] rash, [select value="denies|endorses"] changing mole. [textarea memo="explanation of abnormals if needed" memo_size="small" memo_color="orange" rows="2"]
[/conditional][conditional field="MasterROS" condition="(MasterROS).is('')"][checkbox memo="sleep" name="sleep" value=""][/conditional][conditional field="sleep" condition="(sleep).is('')"]sleep: [select value="denies|endorses"] snoring, [select value="denies|endorses"] difficulty sleeping. [textarea memo="explanation of abnormals if needed" memo_size="small" memo_color="orange" rows="2"]
[/conditional][conditional field="MasterROS" condition="(MasterROS).is('')"][checkbox memo="neurological" name="neurological" value=""][/conditional][conditional field="neurological" condition="(neurological).is('')"]neurological: [select value="denies|endorses"] headache, [select value="denies|endorses"] dizziness, [select value="denies|endorses"] weakness, [select value="denies|endorses"] imbalance, [select value="denies|endorses"] numbness, [select value="denies|endorses"] tingling, [select value="denies|endorses"] swallowing difficulty. [textarea memo="explanation of abnormals if needed" memo_size="small" memo_color="orange" rows="2"]
[/conditional][conditional field="MasterROS" condition="(MasterROS).is('')"][checkbox memo="musculoskeletal" name="musculoskeletal" value=""][/conditional][conditional field="musculoskeletal" condition="(musculoskeletal).is('')"]musculoskeletal: [select value="denies|endorses"] joint pain, [select value="denies|endorses"] muscle pain, [select value="denies|endorses"] muscle weakness. [textarea memo="explanation of abnormals if needed" memo_size="small" memo_color="orange" rows="2"]
[/conditional][conditional field="MasterROS" condition="(MasterROS).is('')"][checkbox memo="psychiatric" name="psychiatric" value=""][/conditional][conditional field="psychiatric" condition="(psychiatric).is('')"]psychiatric: [select value="denies|endorses"] depression, [select value="denies|endorses"] anxiety, [select value="denies|endorses"] suicidal thoughts. [textarea memo="explanation of abnormals if needed" memo_size="small" memo_color="orange" rows="2"]
[/conditional][conditional field="MasterROS" condition="(MasterROS).is('')"][checkbox memo="endocrine" name="endocrine" value=""][/conditional][conditional field="endocrine" condition="(endocrine).is('')"]endocrine: [select value="denies|endorses"] excessive thirst, [select value="denies|endorses"] cold or heat intolerance, [select value="denies|endorses"] breast mass. [textarea memo="explanation of abnormals if needed" memo_size="small" memo_color="orange" rows="2"]
[/conditional][conditional field="MasterROS" condition="(MasterROS).is('')"][checkbox memo="hematologic" name="hematologic" value=""][/conditional][conditional field="hematologic" condition="(hematologic).is('')"]hematologic: [select value="denies|endorses"] unusual bruising or bleeding, [select value="denies|endorses"] enlarged lymph nodes. [textarea memo="explanation of abnormals if needed" memo_size="small" memo_color="orange" rows="2"][/conditional]
ROS

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