{
    "section": "plan",
    "templateSet": "Chiropractic Initial Visit",
    "templates": [
        {
            "text": "Maintenance Visit",
            "template": "{children}",
            "children": [
                {
                    "text": "Maintenance Visit",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Maintenance Visit",
                            "template": "Maintenance Visit"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Spinal Segments Adjusted",
            "template": "The following areas were adjusted:{children}",
            "children": [
                {
                    "text": "Occipital",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Occiput: Left",
                            "template": "Occiput: Left"
                        },
                        {
                            "text": "Occiput: Right",
                            "template": "Occiput: Right"
                        }
                    ]
                },
                {
                    "text": "Cervical",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "C1",
                            "template": "C1"
                        },
                        {
                            "text": "C2",
                            "template": "C2"
                        },
                        {
                            "text": "C3",
                            "template": "C3"
                        },
                        {
                            "text": "C4",
                            "template": "C4"
                        },
                        {
                            "text": "C5",
                            "template": "C5"
                        },
                        {
                            "text": "C6",
                            "template": "C6"
                        },
                        {
                            "text": "C7",
                            "template": "C7"
                        }
                    ]
                },
                {
                    "text": "Thoracic",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "T1",
                            "template": "T1"
                        },
                        {
                            "text": "T2",
                            "template": "T2"
                        },
                        {
                            "text": "T3",
                            "template": "T3"
                        },
                        {
                            "text": "T4",
                            "template": "T4"
                        },
                        {
                            "text": "T5",
                            "template": "T5"
                        },
                        {
                            "text": "T6",
                            "template": "T6"
                        },
                        {
                            "text": "T7",
                            "template": "T7"
                        },
                        {
                            "text": "T8",
                            "template": "T8"
                        },
                        {
                            "text": "T9",
                            "template": "T9"
                        },
                        {
                            "text": "T10",
                            "template": "T10"
                        },
                        {
                            "text": "T11",
                            "template": "T11"
                        },
                        {
                            "text": "T12",
                            "template": "T12"
                        }
                    ]
                },
                {
                    "text": "Lumbar",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "L1",
                            "template": "L1"
                        },
                        {
                            "text": "L2",
                            "template": "L2"
                        },
                        {
                            "text": "L3",
                            "template": "L3"
                        },
                        {
                            "text": "L4",
                            "template": "L4"
                        },
                        {
                            "text": "L5",
                            "template": "L5"
                        }
                    ]
                },
                {
                    "text": "Sacral",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Sacral: Left",
                            "template": "Sacral: Left"
                        },
                        {
                            "text": "Sacral: Right",
                            "template": "Sacral: Right"
                        }
                    ]
                },
                {
                    "text": "Ilium",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Ilium: Left",
                            "template": "Ilium: Left"
                        },
                        {
                            "text": "Ilium: Right",
                            "template": "Ilium: Right"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Extremities Adjusted",
            "template": "The following extremities were adjusted: {children}",
            "children": [
                {
                    "text": "Shoulder",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "left shoulder",
                            "template": "left shoulder"
                        },
                        {
                            "text": "right shoulder",
                            "template": "right shoulder"
                        }
                    ]
                },
                {
                    "text": "Elbow",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "left elbow",
                            "template": "left elbow"
                        },
                        {
                            "text": "right elbow",
                            "template": "right elbow"
                        }
                    ]
                },
                {
                    "text": "Wrist",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "left wrist",
                            "template": "left wrist"
                        },
                        {
                            "text": "right wrist",
                            "template": "right wrist"
                        }
                    ]
                },
                {
                    "text": "Hand",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "left hand",
                            "template": "left hand"
                        },
                        {
                            "text": "right hand",
                            "template": "right hand"
                        }
                    ]
                },
                {
                    "text": "Hip",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "left hip",
                            "template": "left hip"
                        },
                        {
                            "text": "right hip",
                            "template": "right hip"
                        }
                    ]
                },
                {
                    "text": "Knee",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "left knee",
                            "template": "left knee"
                        },
                        {
                            "text": "right knee",
                            "template": "right knee"
                        }
                    ]
                },
                {
                    "text": "Ankle",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "left ankle",
                            "template": "left ankle"
                        },
                        {
                            "text": "right ankle",
                            "template": "right ankle"
                        }
                    ]
                },
                {
                    "text": "Foot",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "left foot",
                            "template": "left foot"
                        },
                        {
                            "text": "right foot",
                            "template": "right foot"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Treatments Provided",
            "template": "Treatment(s) provided:{children}",
            "children": [
                {
                    "text": "Treatments Provided",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Cryotherapy",
                            "template": "Cryotherapy"
                        },
                        {
                            "text": "Electrotherapy",
                            "template": "Electrotherapy"
                        },
                        {
                            "text": "Mechanical traction",
                            "template": "Mechanical traction"
                        },
                        {
                            "text": "Moist Heat",
                            "template": "Moist Heat"
                        },
                        {
                            "text": "OMT",
                            "template": "OMT"
                        },
                        {
                            "text": "Soft Tissue Mobilization",
                            "template": "Soft Tissue Mobilization"
                        },
                        {
                            "text": "Therapeutic Exercises",
                            "template": "Therapeutic Exercises"
                        },
                        {
                            "text": "Ultrasound Modalities",
                            "template": "Ultrasound Modalities"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Prognosis",
            "template": "Prognosis: {children}",
            "children": [
                {
                    "text": "Prognosis",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Fair",
                            "template": "Fair"
                        },
                        {
                            "text": "Good",
                            "template": "Good"
                        },
                        {
                            "text": "Guarded",
                            "template": "Guarded"
                        },
                        {
                            "text": "Improving with Treatment",
                            "template": "Improving with Treatment"
                        },
                        {
                            "text": "Not Improving",
                            "template": "Not Improving"
                        },
                        {
                            "text": "Unstable",
                            "template": "Unstable"
                        }
                    ]
                }
            ]
        },
        {
            "text": "DME",
            "template": "The following DME was given:{children}",
            "children": [
                {
                    "text": "TEN's",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Tens Unit",
                            "template": "Tens Unit"
                        },
                        {
                            "text": "TEN's Garment",
                            "template": "TEN's Garment"
                        }
                    ]
                },
                {
                    "text": "Braces",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "AFO",
                            "template": "AFO"
                        },
                        {
                            "text": "Knee",
                            "template": "Knee"
                        },
                        {
                            "text": "LSO",
                            "template": "LSO"
                        },
                        {
                            "text": "TLSO",
                            "template": "TLSO"
                        },
                        {
                            "text": "Wrist",
                            "template": "Wrist"
                        },
                        {
                            "text": "Elbow",
                            "template": "Elbow"
                        }
                    ]
                },
                {
                    "text": "Traction",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Dakota Unit",
                            "template": "Dakota Unit"
                        },
                        {
                            "text": "C\/S-Traction",
                            "template": "C\/S-Traction"
                        },
                        {
                            "text": "L\/S-Traction",
                            "template": "L\/S-Traction"
                        }
                    ]
                },
                {
                    "text": "Orthotics",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Ft Levlrs: Left",
                            "template": "Ft Levlrs: Left"
                        },
                        {
                            "text": "Ft Levlrs: Bilateral",
                            "template": "Ft Levlrs: Bilateral"
                        },
                        {
                            "text": "Ft Levlrs: Right",
                            "template": "Ft Levlrs: Right"
                        },
                        {
                            "text": "Vasyli: Left",
                            "template": "Vasyli: Left"
                        },
                        {
                            "text": "Vasyli: Bilateral",
                            "template": "Vasyli: Bilateral"
                        },
                        {
                            "text": "Vasyli: Right",
                            "template": "Vasyli: Right"
                        }
                    ]
                },
                {
                    "text": "Home Rehab Kit",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Home Rehab Kit",
                            "template": "Home Rehab Kit"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Patient Instructions",
            "template": "Patient Instructions{children}",
            "children": [
                {
                    "text": "Patient instructions given",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "R.I.C.E. instructions given",
                            "template": "R.I.C.E. instructions given"
                        },
                        {
                            "text": "Quit smoking",
                            "template": "Quit smoking"
                        },
                        {
                            "text": "Follow a healthy diet rich invegetables and low salt\/saturated fat",
                            "template": "Follow a healthy diet rich invegetables and low salt\/saturated fat"
                        }
                    ]
                },
                {
                    "text": "Uncomplicated acute back pain instructions",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Reassurance given about common nature\/typical duration of back pain",
                            "template": "Reassurance given about common nature\/typical duration of back pain"
                        },
                        {
                            "text": "Take OTC ibuprofen or OTC acetaminophen prn",
                            "template": "Take OTC ibuprofen or OTC acetaminophen prn"
                        },
                        {
                            "text": "Heat, ice and massage affected area",
                            "template": "Heat, ice and massage affected area"
                        },
                        {
                            "text": "Continue activities and avoid bed rest",
                            "template": "Continue activities and avoid bed rest"
                        }
                    ]
                },
                {
                    "text": "Uncomplicated chronic back pain instructions",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Therapy goals for pain control discussed",
                            "template": "Therapy goals for pain control discussed"
                        },
                        {
                            "text": "Consider alternative therapy options such as spinal manipulation, yoga, and massage\n                            ",
                            "template": "Consider alternative therapy options such as spinal manipulation, yoga, and massage\n                            "
                        },
                        {
                            "text": "Avoid ongoing use of opioid analgesia",
                            "template": "Avoid ongoing use of opioid analgesia"
                        },
                        {
                            "text": "Stay active",
                            "template": "Stay active"
                        },
                        {
                            "text": "Lose weight",
                            "template": "Lose weight"
                        }
                    ]
                },
                {
                    "text": "Activity instructions",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Activity as tolerated",
                            "template": "Activity as tolerated"
                        },
                        {
                            "text": "Gentle exercise as tolerated",
                            "template": "Gentle exercise as tolerated"
                        },
                        {
                            "text": "Return to normal activity as tolerated",
                            "template": "Return to normal activity as tolerated"
                        },
                        {
                            "text": "OK to resume usual activities as tolerated",
                            "template": "OK to resume usual activities as tolerated"
                        },
                        {
                            "text": "Avoid jumping, squatting, pressure to knee",
                            "template": "Avoid jumping, squatting, pressure to knee"
                        },
                        {
                            "text": "Avoid High Risk",
                            "template": "Avoid High Risk"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Exercises\/Stretches",
            "template": "The following home exercises\/stretches instructions given and demonstrated to\n                        patient:{children}\n                    ",
            "children": [
                {
                    "text": "Exercises\/Stretches",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Pelvic Tilt",
                            "template": "Pelvic Tilt"
                        },
                        {
                            "text": "Pelvic Lift",
                            "template": "Pelvic Lift"
                        },
                        {
                            "text": "Hamstring Stretch",
                            "template": "Hamstring Stretch"
                        },
                        {
                            "text": "Knee to Chest",
                            "template": "Knee to Chest"
                        },
                        {
                            "text": "Half Sit Ups",
                            "template": "Half Sit Ups"
                        },
                        {
                            "text": "Single Leg Raises",
                            "template": "Single Leg Raises"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Restrictions",
            "template": "Restrictions{children}",
            "children": [
                {
                    "text": "Restrictions",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Limited duty",
                            "template": "Limited duty"
                        },
                        {
                            "text": "Light work",
                            "template": "Light work"
                        },
                        {
                            "text": "Off work",
                            "template": "Off work"
                        },
                        {
                            "text": "Unable to return until follow up appointment",
                            "template": "Unable to return until follow up appointment"
                        },
                        {
                            "text": "Return to work, full duty, no restrictions",
                            "template": "Return to work, full duty, no restrictions"
                        },
                        {
                            "text": "Return to work, with restrictions",
                            "template": "Return to work, with restrictions"
                        }
                    ]
                },
                {
                    "text": "Return to clerical work instructions",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Lift with knees (straight back, no stooping) not more than 5 lbs up to 3 times per\n                                hour\n                            ",
                            "template": "Lift with knees (straight back, no stooping) not more than 5 lbs up to 3 times per\n                                hour\n                            "
                        },
                        {
                            "text": "May squat up to 4 times\/hour",
                            "template": "May squat up to 4 times\/hour"
                        },
                        {
                            "text": "Take a 5-minute break at least every 20 minutes when standing or walking",
                            "template": "Take a 5-minute break at least every 20 minutes when standing or walking"
                        },
                        {
                            "text": "Take a 5-minute break every 30 minutes when sitting",
                            "template": "Take a 5-minute break every 30 minutes when sitting"
                        },
                        {
                            "text": "No extremes of extension or flexion allowed",
                            "template": "No extremes of extension or flexion allowed"
                        },
                        {
                            "text": "No extremes of twisting allowed",
                            "template": "No extremes of twisting allowed"
                        },
                        {
                            "text": "No climbing of ladders allowed",
                            "template": "No climbing of ladders allowed"
                        },
                        {
                            "text": "Limit driving to no more than 2 hours\/day",
                            "template": "Limit driving to no more than 2 hours\/day"
                        }
                    ]
                },
                {
                    "text": "Return to manual work instructions",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Lift with knees (straight back, no stooping) not more than 25 lbs up to 15\n                                times\/hour\n                            ",
                            "template": "Lift with knees (straight back, no stooping) not more than 25 lbs up to 15\n                                times\/hour\n                            "
                        },
                        {
                            "text": "May squat up to 16 times\/hour",
                            "template": "May squat up to 16 times\/hour"
                        },
                        {
                            "text": "Take a 10-minute break at least every 1-2 hours when sitting or walking",
                            "template": "Take a 10-minute break at least every 1-2 hours when sitting or walking"
                        },
                        {
                            "text": "Take a 10-minute break every 1-2 hours when sitting",
                            "template": "Take a 10-minute break every 1-2 hours when sitting"
                        },
                        {
                            "text": "Extremes of flexion or extension allowed up to 12 times\/hour",
                            "template": "Extremes of flexion or extension allowed up to 12 times\/hour"
                        },
                        {
                            "text": "Extremes of twisting allowed up to 16 times\/hour",
                            "template": "Extremes of twisting allowed up to 16 times\/hour"
                        },
                        {
                            "text": "Climbing ladders allowed up to 25 rungs, 6 times\/hour",
                            "template": "Climbing ladders allowed up to 25 rungs, 6 times\/hour"
                        },
                        {
                            "text": "May drive car or light truck up to a full work day",
                            "template": "May drive car or light truck up to a full work day"
                        },
                        {
                            "text": "May drive heavy truck up to 4 hours\/day",
                            "template": "May drive heavy truck up to 4 hours\/day"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Referrals",
            "template": "Referrals:{children}",
            "children": [
                {
                    "text": "Referrals",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Refer to GP",
                            "template": "Refer to GP"
                        },
                        {
                            "text": "Refer to ENT",
                            "template": "Refer to ENT"
                        },
                        {
                            "text": "Refer to Cardio",
                            "template": "Refer to Cardio"
                        },
                        {
                            "text": "Refer to INT",
                            "template": "Refer to INT"
                        },
                        {
                            "text": "Refer to Podiatry",
                            "template": "Refer to Podiatry"
                        },
                        {
                            "text": "Refer to Ophthalmology",
                            "template": "Refer to Ophthalmology"
                        },
                        {
                            "text": "Refer to Orthopedic",
                            "template": "Refer to Orthopedic"
                        },
                        {
                            "text": "Refer to Neurologist",
                            "template": "Refer to Neurologist"
                        }
                    ]
                },
                {
                    "text": "Admit to ER\/inpatient care",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Admit to ER",
                            "template": "Admit to ER"
                        },
                        {
                            "text": "Admit to hospital",
                            "template": "Admit to hospital"
                        }
                    ]
                }
            ]
        },
        {
            "text": "[CHIRO RECOMENDATION]",
            "template": "{children}",
            "children": [
                {
                    "text": "----------------------------------------------------------------------------------",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "\n                                --------------------------------------------------------------------------------------------------------\n                            ",
                            "template": "\n                                --------------------------------------------------------------------------------------------------------\n                            "
                        }
                    ]
                }
            ]
        },
        {
            "text": "Chiro Orders (Dx tests + DME)",
            "template": "Chiropractic Physician Orders:{children}",
            "children": [
                {
                    "text": "Diagnostic Tests",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "X-rays ordered + completed",
                            "template": "X-rays ordered + completed"
                        },
                        {
                            "text": "Upper Nerve Conduction Test",
                            "template": "Upper Nerve Conduction Test"
                        },
                        {
                            "text": "Lower Nerve Conduction Test",
                            "template": "Lower Nerve Conduction Test"
                        },
                        {
                            "text": "MRI",
                            "template": "MRI"
                        }
                    ]
                },
                {
                    "text": "DME",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Dakota Unit",
                            "template": "Dakota Unit"
                        },
                        {
                            "text": "Multi Post Collar",
                            "template": "Multi Post Collar"
                        },
                        {
                            "text": "Tens: Symptomatic Area",
                            "template": "Tens: Symptomatic Area"
                        },
                        {
                            "text": "Tens: Cervical",
                            "template": "Tens: Cervical"
                        },
                        {
                            "text": "Tens: Thoracic",
                            "template": "Tens: Thoracic"
                        },
                        {
                            "text": "Tens: Lumbar",
                            "template": "Tens: Lumbar"
                        },
                        {
                            "text": "Tens: Garment",
                            "template": "Tens: Garment"
                        },
                        {
                            "text": "LSO",
                            "template": "LSO"
                        },
                        {
                            "text": "TLSO",
                            "template": "TLSO"
                        },
                        {
                            "text": "Elbow Brace",
                            "template": "Elbow Brace"
                        },
                        {
                            "text": "Wrist Brace",
                            "template": "Wrist Brace"
                        },
                        {
                            "text": "Knee Brace",
                            "template": "Knee Brace"
                        },
                        {
                            "text": "Orthotics",
                            "template": "Orthotics"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Rehab Orders (region)",
            "template": "Physicians orders of rehabilitation for the following regions: {children}",
            "children": [
                {
                    "text": "Entire Spine",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Entire Spine",
                            "template": "Entire Spine"
                        }
                    ]
                },
                {
                    "text": "Cervical Spine",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Cervical Spine",
                            "template": "Cervical Spine"
                        },
                        {
                            "text": "Cervical Spine: Right",
                            "template": "Cervical Spine: Right"
                        },
                        {
                            "text": "Cervical Spine: Left",
                            "template": "Cervical Spine: Left"
                        }
                    ]
                },
                {
                    "text": "Back",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Upper Back",
                            "template": "Upper Back"
                        },
                        {
                            "text": "Upper Back: Right",
                            "template": "Upper Back: Right"
                        },
                        {
                            "text": "Upper Back: Left",
                            "template": "Upper Back: Left"
                        },
                        {
                            "text": "Lower Back",
                            "template": "Lower Back"
                        },
                        {
                            "text": "Lower Back: Right",
                            "template": "Lower Back: Right"
                        },
                        {
                            "text": "Lower Back: Left",
                            "template": "Lower Back: Left"
                        }
                    ]
                },
                {
                    "text": "Shoulder",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Shoulder: Right",
                            "template": "Shoulder: Right"
                        },
                        {
                            "text": "Shoulder: Bilateral",
                            "template": "Shoulder: Bilateral"
                        },
                        {
                            "text": "Shoulder: Left",
                            "template": "Shoulder: Left"
                        }
                    ]
                },
                {
                    "text": "Elbow",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Elbow: Right",
                            "template": "Elbow: Right"
                        },
                        {
                            "text": "Elbow: Bilateral",
                            "template": "Elbow: Bilateral"
                        },
                        {
                            "text": "Elbow: Left",
                            "template": "Elbow: Left"
                        }
                    ]
                },
                {
                    "text": "Hands",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Hand: Right",
                            "template": "Hand: Right"
                        },
                        {
                            "text": "Hand: Bilateral",
                            "template": "Hand: Bilateral"
                        },
                        {
                            "text": "Hand: Left",
                            "template": "Hand: Left"
                        }
                    ]
                },
                {
                    "text": "Ankle",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Ankle: Right",
                            "template": "Ankle: Right"
                        },
                        {
                            "text": "Ankle: Bilateral",
                            "template": "Ankle: Bilateral"
                        },
                        {
                            "text": "Ankle: Left",
                            "template": "Ankle: Left"
                        }
                    ]
                },
                {
                    "text": "Feet",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Foot: Right",
                            "template": "Foot: Right"
                        },
                        {
                            "text": "Feet: Bilateral",
                            "template": "Feet: Bilateral"
                        },
                        {
                            "text": "Foot: Left",
                            "template": "Foot: Left"
                        }
                    ]
                },
                {
                    "text": "Hip",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Hip: Right",
                            "template": "Hip: Right"
                        },
                        {
                            "text": "Hip: Bilateral",
                            "template": "Hip: Bilateral"
                        },
                        {
                            "text": "Hip: Left",
                            "template": "Hip: Left"
                        }
                    ]
                },
                {
                    "text": "Knee",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Knee: Right",
                            "template": "Knee: Right"
                        },
                        {
                            "text": "Knee: Bilateral",
                            "template": "Knee: Bilateral"
                        },
                        {
                            "text": "Knee: Left",
                            "template": "Knee: Left"
                        }
                    ]
                },
                {
                    "text": "Wrist",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Wrist: Right",
                            "template": "Wrist: Right"
                        },
                        {
                            "text": "Wrist: Bilateral",
                            "template": "Wrist: Bilateral"
                        },
                        {
                            "text": "Wrist: Left",
                            "template": "Wrist: Left"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Acupuncture Orders",
            "template": "Acupuncture ordered to for the following regions:{children}",
            "children": [
                {
                    "text": "Ankle",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Ankle: Right",
                            "template": "Ankle: Right"
                        },
                        {
                            "text": "Ankle: Bilateral",
                            "template": "Ankle: Bilateral"
                        },
                        {
                            "text": "Ankle: Left",
                            "template": "Ankle: Left"
                        }
                    ]
                },
                {
                    "text": "Back",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Back: Upper",
                            "template": "Back: Upper"
                        },
                        {
                            "text": "Back: Lower",
                            "template": "Back: Lower"
                        }
                    ]
                },
                {
                    "text": "Elbow",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Elbow: Right",
                            "template": "Elbow: Right"
                        },
                        {
                            "text": "Elbow: Bilateral",
                            "template": "Elbow: Bilateral"
                        },
                        {
                            "text": "Elbow: Left",
                            "template": "Elbow: Left"
                        }
                    ]
                },
                {
                    "text": "Feet",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Foot: Right",
                            "template": "Foot: Right"
                        },
                        {
                            "text": "Feet: Bilateral",
                            "template": "Feet: Bilateral"
                        },
                        {
                            "text": "Foot: Left",
                            "template": "Foot: Left"
                        }
                    ]
                },
                {
                    "text": "Hands",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Hand: Right",
                            "template": "Hand: Right"
                        },
                        {
                            "text": "Hand: Bilateral",
                            "template": "Hand: Bilateral"
                        },
                        {
                            "text": "Hand: Left",
                            "template": "Hand: Left"
                        }
                    ]
                },
                {
                    "text": "Hip",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Hip: Right",
                            "template": "Hip: Right"
                        },
                        {
                            "text": "Hip: Bilateral",
                            "template": "Hip: Bilateral"
                        },
                        {
                            "text": "Hip: Left",
                            "template": "Hip: Left"
                        }
                    ]
                },
                {
                    "text": "Knee",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Knee: Right",
                            "template": "Knee: Right"
                        },
                        {
                            "text": "Knee: Bilateral",
                            "template": "Knee: Bilateral"
                        },
                        {
                            "text": "Knee: Left",
                            "template": "Knee: Left"
                        }
                    ]
                },
                {
                    "text": "Neck",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Neck",
                            "template": "Neck"
                        }
                    ]
                },
                {
                    "text": "Shoulder",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Shoulder: Right",
                            "template": "Shoulder: Right"
                        },
                        {
                            "text": "Shoulder: Bilateral",
                            "template": "Shoulder: Bilateral"
                        },
                        {
                            "text": "Shoulder: Left",
                            "template": "Shoulder: Left"
                        }
                    ]
                },
                {
                    "text": "Wrist",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Wrist: Right",
                            "template": "Wrist: Right"
                        },
                        {
                            "text": "Wrist: Bilateral",
                            "template": "Wrist: Bilateral"
                        },
                        {
                            "text": "Wrist: Left",
                            "template": "Wrist: Left"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Visit Recommendation",
            "template": "The visit recommendation consists of:{children}",
            "children": [
                {
                    "text": "Estimated # of visits",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "# of visits: 12",
                            "template": "# of visits: 12"
                        },
                        {
                            "text": "# of visits: 24",
                            "template": "# of visits: 24"
                        },
                        {
                            "text": "# of visits: 30",
                            "template": "# of visits: 30"
                        },
                        {
                            "text": "# of visits:",
                            "template": "# of visits:"
                        }
                    ]
                },
                {
                    "text": "# of visits\/week",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "3x per week",
                            "template": "3x per week"
                        },
                        {
                            "text": "2x per week",
                            "template": "2x per week"
                        },
                        {
                            "text": "1x per week",
                            "template": "1x per week"
                        },
                        {
                            "text": "# of visits:",
                            "template": "# of visits:"
                        }
                    ]
                },
                {
                    "text": "# of weeks",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "for 2-4 weeks",
                            "template": "for 2-4 weeks"
                        },
                        {
                            "text": "for 4 weeks",
                            "template": "for 4 weeks"
                        },
                        {
                            "text": "for 4-6 weeks",
                            "template": "for 4-6 weeks"
                        },
                        {
                            "text": "for 6-8 weeks",
                            "template": "for 6-8 weeks"
                        },
                        {
                            "text": "# of weeks:",
                            "template": "# of weeks:"
                        }
                    ]
                },
                {
                    "text": "Re-Evaluation",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "re- evaluation date",
                            "template": "re- evaluation date"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Chiro Goals",
            "template": "Goals for adjusting this patient:{children}",
            "children": [
                {
                    "text": "Adjusting Goals",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Decrease compensatory patterns",
                            "template": "Decrease compensatory patterns"
                        },
                        {
                            "text": "Decrease inflammation",
                            "template": "Decrease inflammation"
                        },
                        {
                            "text": "Improve bio-mechanical function",
                            "template": "Improve bio-mechanical function"
                        },
                        {
                            "text": "Improve gait",
                            "template": "Improve gait"
                        },
                        {
                            "text": "Increase activities of daily living",
                            "template": "Increase activities of daily living"
                        },
                        {
                            "text": "Increase mobility",
                            "template": "Increase mobility"
                        },
                        {
                            "text": "Increase stability",
                            "template": "Increase stability"
                        },
                        {
                            "text": "Increase range of motion",
                            "template": "Increase range of motion"
                        },
                        {
                            "text": "Improve\/restore posture",
                            "template": "Improve\/restore posture"
                        }
                    ]
                }
            ]
        }
    ]
}