Subjective/History Elements
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*** PREVENTIVE MEDICINE:
DM is [select name="variable_dm" value="appropriately controlled|poorly controlled."]
- Glucose value today: [text name="variable_BS_today" default="ENTER ACCUCHECK"] mg/dL
- Prescribed medication regimen: [text name="variable_bsmeds" default="DM Meds"]
- Most recent: A1C [text name="variable_last_a1c" default="LAST A1C"]%
- Last eye exam for retinopathy: [date name="variable_eyeexam" default="11/02/2018"]
- Last foot exam: [date name="variable_foot" default="11/02/2018"]

HTN is [select name="variable_htn" value="appropriately controlled|poorly controlled."]
- Current 10 year ASCVD risk: [select name="variable_2" value="recommend high intensity statin therapy|recommend moderate intensity statin therapy|recommend low-intensity statin therapy|no indication for statin therapy at this time"]
- Goal blood pressure is 140/90 mmHg; [select name="variable_BPgoal" value="Patient is at goal.|Patient is not at goal."]
- Prescribed medication regimen: [text name="variable_htnmeds" default="BP meds"]
- Last eye exam for retinopathy: [date name="variable_eyeexam" default="11/02/2018"]

Immunization Hx:
- Pneumococcal vaccine given - [select name="variable_pna" value="Yes|No"]
- Influenza given this season - [select name="variable_inf" value="Yes|No"]
- Hep B - for unvaccinated adults 19-59 given - [select name="variable_hBV" value="Yes|No"]

Screening Procedures:
[text name="variable_1" default="xx/xx/xxxx"] Colonoscopy:
[text name="variable_2" default="xx/xx/xxxx"] Mammogram:
[text name="variable_3" default="xx/xx/xxxx"] Pap-smear:
[text name="variable_4" default="xx/xx/xxxx"] DEXA scan:
*** PREVENTIVE MEDICINE:
DM is
- Glucose value today: mg/dL
- Prescribed medication regimen:
- Most recent: A1C %
- Last eye exam for retinopathy:
- Last foot exam:

HTN is
- Current 10 year ASCVD risk:
- Goal blood pressure is 140/90 mmHg;
- Prescribed medication regimen:
- Last eye exam for retinopathy:

Immunization Hx:
- Pneumococcal vaccine given -
- Influenza given this season -
- Hep B - for unvaccinated adults 19-59 given -

Screening Procedures:
Colonoscopy:
Mammogram:
Pap-smear:
DEXA scan:
Result - Copy and paste this output: