{
    "section": "subjective",
    "templateSet": "Chiropractic Initial Visit",
    "templates": [
        {
            "text": "Reason for visit",
            "template": "Patient presents for {children}.",
            "children": [
                {
                    "text": "initial evaluation of pain sx",
                    "template": "initial evaluation of {children} pain symptoms",
                    "children": [
                        {
                            "text": "back: right lower",
                            "template": "right lower back"
                        },
                        {
                            "text": "back: left lower",
                            "template": "left lower back"
                        },
                        {
                            "text": "back: right upper",
                            "template": "right upper back"
                        },
                        {
                            "text": "back: left upper",
                            "template": "left upper back"
                        },
                        {
                            "text": "thoracic: right",
                            "template": "right thoracic"
                        },
                        {
                            "text": "thoracic: left",
                            "template": "left thoracic"
                        },
                        {
                            "text": "cervical: right",
                            "template": "right cervical"
                        },
                        {
                            "text": "cervical: left",
                            "template": "left cervical"
                        },
                        {
                            "text": "neck",
                            "template": "neck"
                        },
                        {
                            "text": "shoulder: right",
                            "template": "right shoulder"
                        },
                        {
                            "text": "shoulder: left",
                            "template": "left shoulder"
                        },
                        {
                            "text": "arm: right",
                            "template": "right arm"
                        },
                        {
                            "text": "arm: left",
                            "template": "left arm"
                        },
                        {
                            "text": "elbow: right",
                            "template": "right elbow"
                        },
                        {
                            "text": "elbow: left",
                            "template": "left elbow"
                        },
                        {
                            "text": "wrist: right",
                            "template": "right wrist"
                        },
                        {
                            "text": "wrist: left",
                            "template": "left wrist"
                        },
                        {
                            "text": "hand: right",
                            "template": "right hand"
                        },
                        {
                            "text": "hand: left",
                            "template": "left hand"
                        },
                        {
                            "text": "hip: right",
                            "template": "right hip"
                        },
                        {
                            "text": "hip: left",
                            "template": "left hip"
                        },
                        {
                            "text": "knee: right",
                            "template": "right knee"
                        },
                        {
                            "text": "knee: left",
                            "template": "left knee"
                        },
                        {
                            "text": "leg: right",
                            "template": "right leg"
                        },
                        {
                            "text": "leg: left",
                            "template": "left leg"
                        },
                        {
                            "text": "ankle: right",
                            "template": "right ankle"
                        },
                        {
                            "text": "ankle: left",
                            "template": "left ankle"
                        },
                        {
                            "text": "foot: right",
                            "template": "right foot"
                        },
                        {
                            "text": "foot: left",
                            "template": "left foot"
                        }
                    ]
                },
                {
                    "text": "other visit reason (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Date of Injury",
            "template": "Date of injury: {text}.",
            "type": "date"
        },
        {
            "text": "Onset\/Time course",
            "template": "Condition {children}.",
            "children": [
                {
                    "text": "mechanism of onset (specify)",
                    "template": "is reported as being caused by",
                    "type": "alpha"
                },
                {
                    "text": "onset",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "acute onset (new condition)",
                            "template": "is reported to have developed acutely"
                        },
                        {
                            "text": "chronic and ongoing condition",
                            "template": "is chronic and ongoing"
                        }
                    ]
                },
                {
                    "text": "course",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "acutely worse (chronic condition)",
                            "template": "severity is reported to have acutely worsened"
                        },
                        {
                            "text": "progressively worsened",
                            "template": "is reported to have progressively worsened"
                        }
                    ]
                },
                {
                    "text": "frequency",
                    "template": "frequency of pain is",
                    "children": [
                        {
                            "text": "occasional",
                            "template": "occasional"
                        },
                        {
                            "text": "intermittent",
                            "template": "intermittent"
                        },
                        {
                            "text": "frequent",
                            "template": "frequent"
                        },
                        {
                            "text": "constant",
                            "template": "constant"
                        }
                    ]
                },
                {
                    "text": "duration (hours)",
                    "template": "is reported as having been present for {text} hours",
                    "type": "number"
                },
                {
                    "text": "duration (days)",
                    "template": "is reported as having been present for {text} days",
                    "type": "number"
                },
                {
                    "text": "duration (weeks)",
                    "template": "is reported as having been present for {text} weeks",
                    "type": "number"
                },
                {
                    "text": "duration (months)",
                    "template": "is reported as having been present for {text} months",
                    "type": "number"
                },
                {
                    "text": "duration (years)",
                    "template": "is reported as having been present for {text} years",
                    "type": "number"
                },
                {
                    "text": "duration (describe)",
                    "template": "is reported as having been present for {text}",
                    "type": "alpha"
                },
                {
                    "text": "other (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Symptoms\/Functional impact",
            "template": "Back pain is present and described as {children}.",
            "children": [
                {
                    "text": "localization",
                    "template": "affecting the {children}",
                    "children": [
                        {
                            "text": "ankle: right",
                            "template": "right ankle"
                        },
                        {
                            "text": "ankle: left",
                            "template": "left ankle"
                        },
                        {
                            "text": "arm: left",
                            "template": "left arm"
                        },
                        {
                            "text": "arm: right",
                            "template": "right arm"
                        },
                        {
                            "text": "back: left lower",
                            "template": "left lower back"
                        },
                        {
                            "text": "back: right lower",
                            "template": "right lower back"
                        },
                        {
                            "text": "back: left upper",
                            "template": "left upper back"
                        },
                        {
                            "text": "back: right upper",
                            "template": "right upper back"
                        },
                        {
                            "text": "elbow: left",
                            "template": "left elbow"
                        },
                        {
                            "text": "elbow: right",
                            "template": "right elbow"
                        },
                        {
                            "text": "foot: left",
                            "template": "left foot"
                        },
                        {
                            "text": "foot: right",
                            "template": "right foot"
                        },
                        {
                            "text": "hand: left",
                            "template": "left hand"
                        },
                        {
                            "text": "hand: right",
                            "template": "right hand"
                        },
                        {
                            "text": "hip: left",
                            "template": "left hip"
                        },
                        {
                            "text": "hip: right",
                            "template": "right hip"
                        },
                        {
                            "text": "leg: left",
                            "template": "left leg"
                        },
                        {
                            "text": "leg: right",
                            "template": "right leg"
                        },
                        {
                            "text": "neck",
                            "template": "neck"
                        },
                        {
                            "text": "shoulder: left",
                            "template": "left shoulder"
                        },
                        {
                            "text": "shoulder: right",
                            "template": "right shoulder"
                        },
                        {
                            "text": "wrist: left",
                            "template": "left wrist"
                        },
                        {
                            "text": "wrist: right",
                            "template": "right wrist"
                        },
                        {
                            "text": "Rt. Knee",
                            "template": "Rt. Knee"
                        },
                        {
                            "text": "Lt. Knee",
                            "template": "Lt. Knee"
                        }
                    ]
                },
                {
                    "text": "quality",
                    "template": "having {children} quality",
                    "children": [
                        {
                            "text": "aching",
                            "template": "an aching"
                        },
                        {
                            "text": "burning",
                            "template": "a burning"
                        },
                        {
                            "text": "cramping",
                            "template": "a cramping"
                        },
                        {
                            "text": "diffuse",
                            "template": "diffuse"
                        },
                        {
                            "text": "dull",
                            "template": "a dull"
                        },
                        {
                            "text": "electric",
                            "template": "an electric"
                        },
                        {
                            "text": "pressure",
                            "template": "a pressure-like"
                        },
                        {
                            "text": "sharp",
                            "template": "a sharp"
                        },
                        {
                            "text": "spasm",
                            "template": "a spasm-like"
                        },
                        {
                            "text": "sore",
                            "template": "sore"
                        },
                        {
                            "text": "stabbing",
                            "template": "a stabbing"
                        },
                        {
                            "text": "stiff",
                            "template": "stiffness"
                        },
                        {
                            "text": "throbbing",
                            "template": "a throbbing"
                        }
                    ]
                },
                {
                    "text": "radiation",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "into R arm, above the elbow",
                            "template": "radiating down into the R arm (above the elbow)"
                        },
                        {
                            "text": "into L arm, above the elbow",
                            "template": "radiating down into the L arm (above the elbow)"
                        },
                        {
                            "text": "into both arms, above the elbows",
                            "template": "radiating down into both arms (above the elbows)"
                        },
                        {
                            "text": "into R arm, below the elbow",
                            "template": "radiating down into the L arm (below the arm)"
                        },
                        {
                            "text": "into L arm, below the elbow",
                            "template": "radiating down into the L arm (below the elbow)"
                        },
                        {
                            "text": "into both arms, below the elbow",
                            "template": "radiating down into the both arms (below the elbows)"
                        },
                        {
                            "text": "into R leg, above the knee",
                            "template": "radiating down into the R leg (above the knee)"
                        },
                        {
                            "text": "into L leg, above the knee",
                            "template": "radiating down into the L leg (above the knee)"
                        },
                        {
                            "text": "L groin",
                            "template": "radiating into the L groin"
                        },
                        {
                            "text": "R groin",
                            "template": "radiating into the R groin"
                        },
                        {
                            "text": "into both legs, above the knees",
                            "template": "radiating down into both legs (above the knees)"
                        },
                        {
                            "text": "into R leg, below the knee",
                            "template": "radiating down into the R leg (below the knee)"
                        },
                        {
                            "text": "into L leg, below the knee",
                            "template": "radiating down into the L leg (below the knee)"
                        },
                        {
                            "text": "into both legs, below the knees",
                            "template": "radiating down into the both legs (below the knees)"
                        },
                        {
                            "text": "nonradiating",
                            "template": "nonradiating"
                        }
                    ]
                },
                {
                    "text": "severity (0-10, 10=worst)",
                    "template": "having a severity rated as {children}",
                    "children": [
                        {
                            "text": "mild",
                            "template": "mild"
                        },
                        {
                            "text": "moderate",
                            "template": "moderate"
                        },
                        {
                            "text": "severe",
                            "template": "severe"
                        },
                        {
                            "text": "0\/10 (no pain)",
                            "template": "0\/10 (no pain)"
                        },
                        {
                            "text": "+1\/10",
                            "template": "+1\/10 (10=worst)"
                        },
                        {
                            "text": "+2\/10",
                            "template": "+2\/10 (10=worst)"
                        },
                        {
                            "text": "+3\/10",
                            "template": "+3\/10 (10=worst)"
                        },
                        {
                            "text": "+4\/10",
                            "template": "+4\/10 (10=worst)"
                        },
                        {
                            "text": "+5\/10",
                            "template": "+5\/10 (10=worst)"
                        },
                        {
                            "text": "+6\/10",
                            "template": "+6\/10 (10=worst)"
                        },
                        {
                            "text": "+7\/10",
                            "template": "+7\/10 (10=worst)"
                        },
                        {
                            "text": "+8\/10",
                            "template": "+8\/10 (10=worst)"
                        },
                        {
                            "text": "+9\/10",
                            "template": "+9\/10 (10=worst)"
                        },
                        {
                            "text": "+10\/10",
                            "template": "+10\/10 (10=worst)"
                        }
                    ]
                },
                {
                    "text": "functional impact",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "no limitation of physical activity",
                            "template": "no limitation of physical activity"
                        },
                        {
                            "text": "slight limitation of physical activity",
                            "template": "slight limitation of physical activity"
                        },
                        {
                            "text": "marked limitation of physical activity",
                            "template": "marked limitation of physical activity"
                        },
                        {
                            "text": "unable to carry out any activity",
                            "template": "unable to carry out any activity without discomfort"
                        },
                        {
                            "text": "able to work",
                            "template": "able to work"
                        },
                        {
                            "text": "unable to work",
                            "template": "unable to work"
                        },
                        {
                            "text": "able to carry out usual activities",
                            "template": "able to carry out usual activities"
                        },
                        {
                            "text": "unable to carry out usual activities",
                            "template": "unable to carry out usual activities"
                        },
                        {
                            "text": "interferes with appetite",
                            "template": "interferes with appetite"
                        },
                        {
                            "text": "interferes with mood",
                            "template": "interferes with mood"
                        },
                        {
                            "text": "interferes with sleep",
                            "template": "interferes with sleep"
                        },
                        {
                            "text": "interferes with relationships",
                            "template": "interferes with relationships"
                        },
                        {
                            "text": "interferes with ADL's",
                            "template": "interferes with ADL's"
                        }
                    ]
                },
                {
                    "text": "functional impact (describe)",
                    "template": "impaired functional status, described as {text}",
                    "type": "alpha"
                },
                {
                    "text": "other sx\/funct impact (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Pertinent positives\/negatives",
            "template": "Pertinent positive\/negative symptoms include: {children}.",
            "children": [
                {
                    "text": "abnormal weight change",
                    "template": "abnormal weight change",
                    "type": "plus-minus"
                },
                {
                    "text": "back",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "muscle spasm",
                            "template": "back muscle spasm",
                            "type": "plus-minus"
                        },
                        {
                            "text": "pain",
                            "template": "back pain",
                            "type": "plus-minus"
                        },
                        {
                            "text": "pain with movement",
                            "template": "back pain with movement",
                            "type": "plus-minus"
                        },
                        {
                            "text": "stiffness",
                            "template": "neck stiffness",
                            "type": "plus-minus"
                        },
                        {
                            "text": "tenderness",
                            "template": "back tenderness",
                            "type": "plus-minus"
                        }
                    ]
                },
                {
                    "text": "balance, difficulty",
                    "template": "difficulty with balance",
                    "type": "plus-minus"
                },
                {
                    "text": "diet, poor",
                    "template": "poor diet",
                    "type": "plus-minus"
                },
                {
                    "text": "dizziness",
                    "template": "dizziness",
                    "type": "plus-minus"
                },
                {
                    "text": "fever",
                    "template": "fever",
                    "type": "plus-minus"
                },
                {
                    "text": "headache",
                    "template": "headache",
                    "type": "plus-minus"
                },
                {
                    "text": "hypomobility",
                    "template": "hypomobility",
                    "type": "plus-minus"
                },
                {
                    "text": "joint pain",
                    "template": "joint pain",
                    "type": "plus-minus"
                },
                {
                    "text": "LE edema",
                    "template": "lower extremity edema",
                    "type": "plus-minus"
                },
                {
                    "text": "LE numbness",
                    "template": "lower extremity numbness",
                    "type": "plus-minus"
                },
                {
                    "text": "LE weakness",
                    "template": "lower extremity weakness",
                    "type": "plus-minus"
                },
                {
                    "text": "malaise",
                    "template": "malaise",
                    "type": "plus-minus"
                },
                {
                    "text": "multiple tender points",
                    "template": "multiple tender points",
                    "type": "plus-minus"
                },
                {
                    "text": "myalgias",
                    "template": "myalgias",
                    "type": "plus-minus"
                },
                {
                    "text": "nausea",
                    "template": "nausea",
                    "type": "plus-minus"
                },
                {
                    "text": "neck",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "arm weakness",
                            "template": "arm weakness",
                            "type": "plus-minus"
                        },
                        {
                            "text": "muscle spasm",
                            "template": "neck muscle spasm",
                            "type": "plus-minus"
                        },
                        {
                            "text": "pain",
                            "template": "neck pain",
                            "type": "plus-minus"
                        },
                        {
                            "text": "pain with movement",
                            "template": "neck pain with movement",
                            "type": "plus-minus"
                        },
                        {
                            "text": "stiffness",
                            "template": "neck stiffness",
                            "type": "plus-minus"
                        },
                        {
                            "text": "tenderness",
                            "template": "neck tenderness",
                            "type": "plus-minus"
                        }
                    ]
                },
                {
                    "text": "numbness",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "R arm",
                            "template": "right arm",
                            "type": "plus-minus"
                        },
                        {
                            "text": "L arm",
                            "template": "left arm",
                            "type": "plus-minus"
                        },
                        {
                            "text": "B arm",
                            "template": "bilateral arms",
                            "type": "plus-minus"
                        },
                        {
                            "text": "R leg",
                            "template": "right leg",
                            "type": "plus-minus"
                        },
                        {
                            "text": "L leg",
                            "template": "left leg",
                            "type": "plus-minus"
                        },
                        {
                            "text": "B leg",
                            "template": "bilateral legs",
                            "type": "plus-minus"
                        }
                    ]
                },
                {
                    "text": "stress",
                    "template": "stress",
                    "type": "plus-minus"
                },
                {
                    "text": "tingling",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "R arm",
                            "template": "right arm",
                            "type": "plus-minus"
                        },
                        {
                            "text": "L arm",
                            "template": "left arm",
                            "type": "plus-minus"
                        },
                        {
                            "text": "B arm",
                            "template": "bilateral arms",
                            "type": "plus-minus"
                        },
                        {
                            "text": "R leg",
                            "template": "right leg",
                            "type": "plus-minus"
                        },
                        {
                            "text": "L leg",
                            "template": "left leg",
                            "type": "plus-minus"
                        },
                        {
                            "text": "B leg",
                            "template": "bilateral legs",
                            "type": "plus-minus"
                        }
                    ]
                },
                {
                    "text": "UE edema",
                    "template": "upper extremity edema",
                    "type": "plus-minus"
                },
                {
                    "text": "UE numbness",
                    "template": "upper extremity numbness",
                    "type": "plus-minus"
                },
                {
                    "text": "UE weakness",
                    "template": "upper extremity weakness",
                    "type": "plus-minus"
                },
                {
                    "text": "vomiting",
                    "template": "vomiting",
                    "type": "plus-minus"
                },
                {
                    "text": "widespread pain",
                    "template": "widespread pain",
                    "type": "plus-minus"
                },
                {
                    "text": "other pertinent sx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Exacerbating\/Alleviating factors",
            "template": "Patient reports that {children}.",
            "children": [
                {
                    "text": "associated injury\/activity (specify)",
                    "template": "the condition was caused by {text}",
                    "type": "alpha"
                },
                {
                    "text": "activity",
                    "template": "activity {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "improves sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been observed",
                            "template": "has not been observed"
                        }
                    ]
                },
                {
                    "text": "exercise",
                    "template": "exercise {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "improves sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been tried",
                            "template": "has not been tried"
                        }
                    ]
                },
                {
                    "text": "lying down",
                    "template": "lying down {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "improves sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been observed",
                            "template": "has not been observed"
                        }
                    ]
                },
                {
                    "text": "prolonged work at desk",
                    "template": "prolonged work at desk {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "improves sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been observed",
                            "template": "has not been observed"
                        }
                    ]
                },
                {
                    "text": "rest",
                    "template": "rest {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "improves sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been observed",
                            "template": "has not been observed"
                        }
                    ]
                },
                {
                    "text": "rising in morning",
                    "template": "rising in the morning {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "improves sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been observed",
                            "template": "has not been observed"
                        }
                    ]
                },
                {
                    "text": "stress",
                    "template": "stress {children}",
                    "children": [
                        {
                            "text": "worsens sx",
                            "template": "worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been observed",
                            "template": "has not been observed"
                        }
                    ]
                },
                {
                    "text": "walking",
                    "template": "walking {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "improves sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been observed",
                            "template": "has not been observed"
                        }
                    ]
                },
                {
                    "text": "walking up stairs",
                    "template": "walking up stairs {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "improves sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been observed",
                            "template": "has not been observed"
                        }
                    ]
                },
                {
                    "text": "chiropractic",
                    "template": "chiropractic treatment {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "improves sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been tried",
                            "template": "has not been tried"
                        }
                    ]
                },
                {
                    "text": "massage",
                    "template": "massage {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "improves sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been tried",
                            "template": "has not been tried"
                        }
                    ]
                },
                {
                    "text": "PT",
                    "template": "physical therapy {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "improves sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been tried",
                            "template": "has not been tried"
                        }
                    ]
                },
                {
                    "text": "yoga",
                    "template": "yoga {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "improves sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been tried",
                            "template": "has not been tried"
                        }
                    ]
                },
                {
                    "text": "surgery",
                    "template": "surgery",
                    "children": [
                        {
                            "text": "has not not helped",
                            "template": "has not not helped"
                        },
                        {
                            "text": "have helped",
                            "template": "have helped"
                        },
                        {
                            "text": "worsened pain",
                            "template": "worsened pain"
                        },
                        {
                            "text": "have not changed pain",
                            "template": "have not changed pain"
                        }
                    ]
                },
                {
                    "text": "acetaminophen",
                    "template": "acetaminophen {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "improves sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been tried",
                            "template": "has not been tried"
                        }
                    ]
                },
                {
                    "text": "opioids",
                    "template": "opioids {children}",
                    "children": [
                        {
                            "text": "improve sx",
                            "template": "improve sx"
                        },
                        {
                            "text": "worsen sx",
                            "template": "worsen sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "have no effect on sx"
                        },
                        {
                            "text": "have not been tried",
                            "template": "have not been tried"
                        }
                    ]
                },
                {
                    "text": "NSAIDs",
                    "template": "NSAIDs {children}",
                    "children": [
                        {
                            "text": "improve sx",
                            "template": "improve sx"
                        },
                        {
                            "text": "worsen sx",
                            "template": "worsen sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "have no effect on sx"
                        },
                        {
                            "text": "have not been tried",
                            "template": "have not been tried"
                        }
                    ]
                },
                {
                    "text": "other (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Secondary Complaints (describe)",
            "template": "Secondary Complaints: {text}.",
            "type": "alpha"
        },
        {
            "text": "Medical Hx specific to visit",
            "template": "Medical history includes {children}.",
            "children": [
                {
                    "text": "cancer history (describe)",
                    "template": "history of cancer: {text}",
                    "type": "alpha"
                },
                {
                    "text": "back injury history (describe)",
                    "template": "history of back injury: {text}",
                    "type": "alpha"
                },
                {
                    "text": "back surgery history (describe)",
                    "template": "history of back surgery: {text}",
                    "type": "alpha"
                },
                {
                    "text": "DDD",
                    "template": "DDD",
                    "type": "plus-minus"
                },
                {
                    "text": "depression",
                    "template": "depression",
                    "type": "plus-minus"
                },
                {
                    "text": "DJD",
                    "template": "DJD",
                    "type": "plus-minus"
                },
                {
                    "text": "facet syndrome",
                    "template": "facet syndrome",
                    "type": "plus-minus"
                },
                {
                    "text": "fibromyalgia",
                    "template": "fibromyalgia",
                    "type": "plus-minus"
                },
                {
                    "text": "osteoarthritis",
                    "template": "osteoarthritis",
                    "type": "plus-minus"
                },
                {
                    "text": "osteomyelitis",
                    "template": "osteomyelitis",
                    "type": "plus-minus"
                },
                {
                    "text": "osteoporosis",
                    "template": "osteoporosis",
                    "type": "plus-minus"
                },
                {
                    "text": "rheumatoid arthritis",
                    "template": "rheumatoid arthritis",
                    "type": "plus-minus"
                },
                {
                    "text": "scoliosis",
                    "template": "scoliosis",
                    "type": "plus-minus"
                },
                {
                    "text": "stenosis",
                    "template": "stenosis",
                    "type": "plus-minus"
                },
                {
                    "text": "overweight\/obesity",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "overweight",
                            "template": "overweight",
                            "type": "plus-minus"
                        },
                        {
                            "text": "obese",
                            "template": "obese",
                            "type": "plus-minus"
                        },
                        {
                            "text": "morbid obesity",
                            "template": "morbid obesity",
                            "type": "plus-minus"
                        }
                    ]
                },
                {
                    "text": "obesity contributing factors (describe)",
                    "template": "obesity contributing factors {text}",
                    "type": "alpha"
                },
                {
                    "text": "trauma history (describe)",
                    "template": "history of trauma: {text}",
                    "type": "alpha"
                },
                {
                    "text": "other medical Hx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Lifestyle\/Environment factors",
            "template": "Lifestyle\/Environment factors include {children}.",
            "children": [
                {
                    "text": "occupation (specify)",
                    "template": "{text}",
                    "type": "alpha"
                },
                {
                    "text": "alcohol use",
                    "template": "alcohol use",
                    "type": "plus-minus"
                },
                {
                    "text": "cocaine use",
                    "template": "cocaine use",
                    "type": "plus-minus"
                },
                {
                    "text": "methamphetamine use",
                    "template": "methamphetamine use",
                    "type": "plus-minus"
                },
                {
                    "text": "high fat diet",
                    "template": "high fat diet",
                    "type": "plus-minus"
                },
                {
                    "text": "regular exercise",
                    "template": "regular exercise",
                    "type": "plus-minus"
                },
                {
                    "text": "other lifestyle\/exposure (specify)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Smoking status",
            "template": "Smoking status: {children}.",
            "children": [
                {
                    "text": "nonsmoker",
                    "template": "nonsmoker"
                },
                {
                    "text": "tobacco abuse",
                    "template": "tobacco abuse",
                    "type": "plus-minus"
                },
                {
                    "text": "tobacco dependence",
                    "template": "tobacco dependence",
                    "type": "plus-minus"
                },
                {
                    "text": "tobacco products used",
                    "template": "tobacco products used include {children}",
                    "children": [
                        {
                            "text": "cigarettes",
                            "template": "cigarettes"
                        },
                        {
                            "text": "cigars",
                            "template": "cigars"
                        },
                        {
                            "text": "pipes",
                            "template": "pipes"
                        },
                        {
                            "text": "water pipes",
                            "template": "water pipes"
                        },
                        {
                            "text": "chew",
                            "template": "chew"
                        },
                        {
                            "text": "snuff",
                            "template": "snuff"
                        }
                    ]
                },
                {
                    "text": "packs per day (specify)",
                    "template": "{text} packs per day",
                    "type": "number"
                },
                {
                    "text": "age at smoking onset (specify)",
                    "template": "started smoking at age {text}",
                    "type": "number"
                },
                {
                    "text": "smoking duration (months)",
                    "template": "smoking duration is {text} months",
                    "type": "number"
                },
                {
                    "text": "smoking duration (years)",
                    "template": "smoking duration is {text} years",
                    "type": "number"
                },
                {
                    "text": "tobacco withdrawal",
                    "template": "tobacco withdrawal",
                    "type": "plus-minus"
                },
                {
                    "text": "tobacco remission",
                    "template": "tobacco remission",
                    "type": "plus-minus"
                },
                {
                    "text": "hx of nicotine dependence (describe)",
                    "template": "{text}",
                    "type": "alpha"
                },
                {
                    "text": "second hand smoke type\/exposure (describe)",
                    "template": "{text}",
                    "type": "alpha"
                },
                {
                    "text": "other (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        }
    ]
}