CAUTION: This page needs to be reviewed and categorized.
[text name="variable_1" default="BED MOBILITY:
"][textarea name="variable_1" default=""]
[text name="variable_2" default="TRANSFERS:
"][textarea name="variable_2" default=""]
[text name="variable_3" default="UB BATHING:
"][textarea name="variable_3" default=""]
[text name="variable_4" default="LB BATHING:
"][textarea name="variable_4" default=""]
[text name="variable_5" default="UB DRESSING:
"][textarea name="variable_5" default=""]
[text name="variable_6" default="LB DRESSING:
"][textarea name="variable_6" default=""]
[text name="variable_7" default="HYGEINE:
"][textarea name="variable_7" default=""]
[text name="variable_8" default="TOILETING :
"][textarea name="variable_8" default=""]
[text name="variable_9" default="EATING:
"][textarea name="variable_9" default=""]
[text name="variable_10" default="AMBULATION:
"][textarea name="variable_10" default=""]

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0, 20 form elements, 10 text boxes, 10 text areas, 20 total clicks
Questions/General site feedback · Help Ticket

Send Feedback for this SOAPnote

Your email address will not be published. Required fields are marked *

More SOAPnotes by this Author: