{
    "section": "plan",
    "templateSet": "Well Child Visit, 10-18 Years",
    "templates": [
        {
            "text": "Imaging",
            "template": "Imaging{children}",
            "children": [
                {
                    "text": "CT",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "CT head",
                            "template": "CT head"
                        },
                        {
                            "text": "CT abdomen",
                            "template": "CT abdomen"
                        }
                    ]
                },
                {
                    "text": "Ultrasound",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "US renal",
                            "template": "US renal"
                        },
                        {
                            "text": "US hip",
                            "template": "US hip"
                        },
                        {
                            "text": "US spine",
                            "template": "US spine"
                        }
                    ]
                },
                {
                    "text": "Imaging",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "X-ray",
                            "template": "X-ray"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Labs",
            "template": "Labs{children}",
            "children": [
                {
                    "text": "Blood chemistry\/Hematology",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "CBC",
                            "template": "CBC"
                        },
                        {
                            "text": "CBC w\/ auto diff",
                            "template": "CBC w\/ auto diff"
                        },
                        {
                            "text": "Metabolic panel, basic (BMP), serum",
                            "template": "Metabolic panel, basic (BMP), serum"
                        },
                        {
                            "text": "Metabolic panel, comprehensive (CMP), serum",
                            "template": "Metabolic panel, comprehensive (CMP), serum"
                        },
                        {
                            "text": "Lipid panel",
                            "template": "Lipid panel"
                        },
                        {
                            "text": "Hepatic function panel (LFTs)",
                            "template": "Hepatic function panel (LFTs)"
                        },
                        {
                            "text": "Hepatitis screening panel",
                            "template": "Hepatitis screening panel"
                        },
                        {
                            "text": "Magnesium, serum",
                            "template": "Magnesium, serum"
                        },
                        {
                            "text": "Glucose, fasting, plasma",
                            "template": "Glucose, fasting, plasma"
                        },
                        {
                            "text": "Glucose, fingerstick",
                            "template": "Glucose, fingerstick"
                        },
                        {
                            "text": "Hemoglobin A1c (HbA1c), blood",
                            "template": "Hemoglobin A1c (HbA1c), blood"
                        },
                        {
                            "text": "TSH (thyroid-stimulating hormone), serum",
                            "template": "TSH (thyroid-stimulating hormone), serum"
                        },
                        {
                            "text": "Thyroxine (T4), free, serum",
                            "template": "Thyroxine (T4), free, serum"
                        },
                        {
                            "text": "PT (prothrombin time)",
                            "template": "PT (prothrombin time)"
                        },
                        {
                            "text": "PT\/INR",
                            "template": "PT\/INR"
                        },
                        {
                            "text": "Uric acid, serum",
                            "template": "Uric acid, serum"
                        },
                        {
                            "text": "Erythrocyte sedimentation rate (ESR)",
                            "template": "Erythrocyte sedimentation rate (ESR)"
                        },
                        {
                            "text": "C-reactive protein, high-sensitivity (hs-CRP), serum",
                            "template": "C-reactive protein, high-sensitivity (hs-CRP), serum"
                        },
                        {
                            "text": "Creatinine kinase (CK), serum",
                            "template": "Creatinine kinase (CK), serum"
                        },
                        {
                            "text": "Vitamin D, 25-OH, serum",
                            "template": "Vitamin D, 25-OH, serum"
                        },
                        {
                            "text": "Parathyroid hormone (PTH), serum",
                            "template": "Parathyroid hormone (PTH), serum"
                        },
                        {
                            "text": "HIV-1+HIV-2 antibody screen, serum",
                            "template": "HIV-1+HIV-2 antibody screen, serum"
                        },
                        {
                            "text": "CD4 T-cell count, blood",
                            "template": "CD4 T-cell count, blood"
                        },
                        {
                            "text": "RPR (rapid plasma reagin), serum",
                            "template": "RPR (rapid plasma reagin), serum"
                        },
                        {
                            "text": "FTA-ABS (fluorescent treponemal antibody absorption test)",
                            "template": "FTA-ABS (fluorescent treponemal antibody absorption test)"
                        },
                        {
                            "text": "Beta-hCG, qualitative, serum",
                            "template": "Beta-hCG, qualitative, serum"
                        },
                        {
                            "text": "Pap smear",
                            "template": "Pap smear"
                        }
                    ]
                },
                {
                    "text": "Urine tests",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Urinalysis, complete (with micro)",
                            "template": "Urinalysis, complete (with micro)"
                        },
                        {
                            "text": "Urine dipstick",
                            "template": "Urine dipstick"
                        },
                        {
                            "text": "Culture, urine, bacterial",
                            "template": "Culture, urine, bacterial"
                        },
                        {
                            "text": "Microalbumin, random, urine",
                            "template": "Microalbumin, random, urine"
                        },
                        {
                            "text": "Beta-hCG, qualitative, urine",
                            "template": "Beta-hCG, qualitative, urine"
                        },
                        {
                            "text": "Chlamydia trachomatis, nucleic acid amplification, urine",
                            "template": "Chlamydia trachomatis, nucleic acid amplification, urine"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Immunizations",
            "template": "Immunizations{children}",
            "children": [
                {
                    "text": "Immunizations",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Vaccination, Dtap",
                            "template": "Vaccination, Dtap"
                        },
                        {
                            "text": "Vaccination, hepatitis A",
                            "template": "Vaccination, hepatitis A"
                        },
                        {
                            "text": "Vaccination, hepatitis B",
                            "template": "Vaccination, hepatitis B"
                        },
                        {
                            "text": "Vaccination, Hib",
                            "template": "Vaccination, Hib"
                        },
                        {
                            "text": "Vaccination, HPV",
                            "template": "Vaccination, HPV"
                        },
                        {
                            "text": "Vaccination, influenza",
                            "template": "Vaccination, influenza"
                        },
                        {
                            "text": "Vaccination, MCV",
                            "template": "Vaccination, MCV"
                        },
                        {
                            "text": "Vaccination, MMR",
                            "template": "Vaccination, MMR"
                        },
                        {
                            "text": "Vaccination, polio, inactivated",
                            "template": "Vaccination, polio, inactivated"
                        },
                        {
                            "text": "Vaccination, pneumococcus, conjugate",
                            "template": "Vaccination, pneumococcus, conjugate"
                        },
                        {
                            "text": "Vaccination, rotavirus",
                            "template": "Vaccination, rotavirus"
                        },
                        {
                            "text": "Vaccination, varicella",
                            "template": "Vaccination, varicella"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Procedures",
            "template": "Procedures{children}",
            "children": [
                {
                    "text": "Diagnostic",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "PPD (purified protein derivative) skin test",
                            "template": "PPD (purified protein derivative) skin test"
                        },
                        {
                            "text": "EKG, 12-lead",
                            "template": "EKG, 12-lead"
                        },
                        {
                            "text": "pelvic exam",
                            "template": "pelvic exam"
                        },
                        {
                            "text": "pap smear",
                            "template": "pap smear"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Patient Instructions",
            "template": "Patient Instructions{children}",
            "children": [
                {
                    "text": "Safe environment",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Maintain a smoke-free home environment",
                            "template": "Maintain a smoke-free home environment"
                        },
                        {
                            "text": "Sunscreen instructions given (for outdoor play)",
                            "template": "Sunscreen instructions given (for outdoor play)"
                        },
                        {
                            "text": "Seat belt safety (self and passengers)",
                            "template": "Seat belt safety (self and passengers)"
                        },
                        {
                            "text": "Gun safety",
                            "template": "Gun safety"
                        },
                        {
                            "text": "Safe driving (distractions, texting, cell phone use, under the influence)",
                            "template": "Safe driving (distractions, texting, cell phone use, under the influence)"
                        }
                    ]
                },
                {
                    "text": "Diet and hygiene",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Eat meals together",
                            "template": "Eat meals together"
                        },
                        {
                            "text": "Limit sugary drinks and fast food",
                            "template": "Limit sugary drinks and fast food"
                        },
                        {
                            "text": "Follow a healthy diet rich in vegetables and low in salt\/saturated fat",
                            "template": "Follow a healthy diet rich in vegetables and low in salt\/saturated fat"
                        },
                        {
                            "text": "Multivitamin supplement",
                            "template": "Multivitamin supplement"
                        },
                        {
                            "text": "Contact use",
                            "template": "Contact use"
                        },
                        {
                            "text": "Importance dental hygiene and routine care",
                            "template": "Importance dental hygiene and routine care"
                        }
                    ]
                },
                {
                    "text": "Developmental support",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Limit rules, but consistently reinforce the ones that are set",
                            "template": "Limit rules, but consistently reinforce the ones that are set"
                        },
                        {
                            "text": "Participation in team sports, clubs or other group activities",
                            "template": "Participation in team sports, clubs or other group activities"
                        },
                        {
                            "text": "Relationships with friends, peers (bullying, peer pressure)",
                            "template": "Relationships with friends, peers (bullying, peer pressure)"
                        },
                        {
                            "text": "Talk about substance use (drugs, alcohol, cigarettes and prescription abuse)",
                            "template": "Talk about substance use (drugs, alcohol, cigarettes and prescription abuse)"
                        },
                        {
                            "text": "Puberty, sexual education and safe practices",
                            "template": "Puberty, sexual education and safe practices"
                        },
                        {
                            "text": "Importance of self-esteem",
                            "template": "Importance of self-esteem"
                        },
                        {
                            "text": "Daily regular exercise\/physical activity for 1 hour a day",
                            "template": "Daily regular exercise\/physical activity for 1 hour a day"
                        },
                        {
                            "text": "Limit screen time to < 2 hours a day",
                            "template": "Limit screen time to < 2 hours a day"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Follow-up, Referrals",
            "template": "Follow-up, Referrals{children}",
            "children": [
                {
                    "text": "Return visits",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Return visit as needed",
                            "template": "Return visit as needed"
                        },
                        {
                            "text": "Return visit in 1 year",
                            "template": "Return visit in 1 year"
                        }
                    ]
                },
                {
                    "text": "Admit to ER",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Admit to ER",
                            "template": "Admit to ER"
                        }
                    ]
                },
                {
                    "text": "Referrals",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Refer to Allergy",
                            "template": "Refer to Allergy"
                        },
                        {
                            "text": "Refer to Audiology",
                            "template": "Refer to Audiology"
                        },
                        {
                            "text": "Refer to Child Development",
                            "template": "Refer to Child Development"
                        },
                        {
                            "text": "Refer to Child Protective Services",
                            "template": "Refer to Child Protective Services"
                        },
                        {
                            "text": "Refer to Dermatology",
                            "template": "Refer to Dermatology"
                        },
                        {
                            "text": "Refer to ENT",
                            "template": "Refer to ENT"
                        },
                        {
                            "text": "Refer to Ophthalmology",
                            "template": "Refer to Ophthalmology"
                        },
                        {
                            "text": "Refer to Pediatric Cardiology",
                            "template": "Refer to Pediatric Cardiology"
                        },
                        {
                            "text": "Refer to Pediatric GI",
                            "template": "Refer to Pediatric GI"
                        },
                        {
                            "text": "Refer to Pediatric Neurology",
                            "template": "Refer to Pediatric Neurology"
                        },
                        {
                            "text": "Refer to Pediatric Pulmonary",
                            "template": "Refer to Pediatric Pulmonary"
                        },
                        {
                            "text": "Refer to Pediatric Surgery",
                            "template": "Refer to Pediatric Surgery"
                        },
                        {
                            "text": "Refer to Psychiatry",
                            "template": "Refer to Psychiatry"
                        },
                        {
                            "text": "Refer to Physical Therapy",
                            "template": "Refer to Physical Therapy"
                        },
                        {
                            "text": "Refer to Public Health Department Nurse",
                            "template": "Refer to Public Health Department Nurse"
                        },
                        {
                            "text": "Refer to Social Services",
                            "template": "Refer to Social Services"
                        },
                        {
                            "text": "Refer to Women, Infants, and Children Program (WIC)",
                            "template": "Refer to Women, Infants, and Children Program (WIC)"
                        }
                    ]
                }
            ]
        }
    ]
}