HomeHealth

CAUTION: This page needs to be reviewed and categorized.
CC: [checklist name="variable_1" value="Establish care|Home health evaluation| Medication refill"]

HPI: [textarea name="variable_1" default="sample text" [textarea cols="40" rows="3"]

Review of Systems

CONSTITUTIONAL:[checkbox name="variable_1" value="Chills|Fatigue|Fever|Weight gain|Weight loss"]

HEENT:[checkbox name="variable_1" value="Hearing loss|Sinus pressure|Visual changes"]

RESPIRATORY:[checkbox name="variable_1" value="Cough|Shortness of|Wheezing"]

CARDIOVASCULAR:[checkbox name="variable_1" value="Chest pain|Edema|Palpitations|Claudication (pain with walking)"]

GASTROINTESTINAL:[checkbox name="variable_1" value="Abdominal pain|Blood in stool|Constipation|Diarrhea|Heartburn|Loss of appetite|Nausea|Vomiting|Incontinence"]

GENITOURINARY:[checkbox name="variable_1" value="Dysuria|Polyuria|Urinary frequency|Incontinence"]

ENDOCRINE:[checkbox name="variable_1" value="Cold intolerance|Heat intolerance|excessive thrist|Excessive hunger"]

NEUROLOGICAL:[checkbox name="variable_1" value="Dizziness|Numbness|Weakness|Headaches|Seizures|Tremors"]

PSYCHIATRIC:[checkbox name="variable_1" value="Anxiety|Depression"]

INTEGUMENTARY:[checkbox name="variable_1" value="Rash|Skin lesion|Mole changes"]

MUSCULOSKELETAL:[checkbox name="variable_1" value="Back pain|Joint pain|Joint swelling|Neck pain"]

CC:

HPI:


Review of Systems

CONSTITUTIONAL:

HEENT:

RESPIRATORY:

CARDIOVASCULAR:

GASTROINTESTINAL:

GENITOURINARY:

ENDOCRINE:

NEUROLOGICAL:

PSYCHIATRIC:

INTEGUMENTARY:

MUSCULOSKELETAL:

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.92, 13 form elements, 16 boilerplate words, 1 text areas, 11 checkboxes, 1 check lists, 51 total clicks
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