{
    "section": "subjective",
    "templateSet": "Dizziness\/Vertigo",
    "templates": [
        {
            "text": "Reason for visit",
            "template": "Patient presents for {children}.",
            "children": [
                {
                    "text": "new onset dizziness\/vertigo evaluation",
                    "template": "evaluation of new onset of dizziness\/vertigo"
                },
                {
                    "text": "initial evaluation of dizziness\/vertigo",
                    "template": "initial evaluation of dizziness\/vertigo"
                },
                {
                    "text": "follow-up evaluation of dizziness\/vertigo",
                    "template": "follow-up evaluation of dizziness\/vertigo"
                },
                {
                    "text": "ongoing management of dizziness\/vertigo",
                    "template": "ongoing management of dizziness\/vertigo"
                },
                {
                    "text": "Visit reason (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Symptoms",
            "template": "Patient reports\/denies the following symptoms related to the current visit: {children}.\n                    ",
            "children": [
                {
                    "text": "lightheadedness",
                    "template": "lightheadedness",
                    "type": "plus-minus"
                },
                {
                    "text": "spinning sensation",
                    "template": "spinning sensation",
                    "type": "plus-minus"
                },
                {
                    "text": "swaying sensation",
                    "template": "swaying sensation",
                    "type": "plus-minus"
                },
                {
                    "text": "tilting sensation",
                    "template": "tilting sensation",
                    "type": "plus-minus"
                },
                {
                    "text": "unsteadiness",
                    "template": "unsteadiness",
                    "type": "plus-minus"
                },
                {
                    "text": "difficulty balancing",
                    "template": "difficulty balancing",
                    "type": "plus-minus"
                },
                {
                    "text": "feeling faint",
                    "template": "feeling faint",
                    "type": "plus-minus"
                },
                {
                    "text": "spatial disorientation",
                    "template": "spatial disorientation",
                    "type": "plus-minus"
                },
                {
                    "text": "oscillopsia",
                    "template": "oscillopsia",
                    "type": "plus-minus"
                },
                {
                    "text": "other (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Onset\/Time course",
            "template": "Sx onset and time course: Patient reports {children}.",
            "children": [
                {
                    "text": "single episode",
                    "template": "single episode"
                },
                {
                    "text": "recurrent episodes",
                    "template": "recurrent episodes"
                },
                {
                    "text": "acute onset",
                    "template": "acute onset"
                },
                {
                    "text": "gradual onset",
                    "template": "gradual onset"
                },
                {
                    "text": "constant sx",
                    "template": "constant sx"
                },
                {
                    "text": "intermittent sx",
                    "template": "intermittent sx"
                },
                {
                    "text": "Hours of sx (specify)",
                    "template": "{text} hours sx",
                    "type": "number"
                },
                {
                    "text": "Days of sx (specify)",
                    "template": "{text} days sx",
                    "type": "number"
                },
                {
                    "text": "Weeks of sx (specify)",
                    "template": "{text} weeks sx",
                    "type": "number"
                },
                {
                    "text": "Months of sx (specify)",
                    "template": "{text} months sx",
                    "type": "number"
                },
                {
                    "text": "Years of sx (specify)",
                    "template": "{text} years sx",
                    "type": "number"
                },
                {
                    "text": "Duration of sx (specify)",
                    "template": "{text} sx",
                    "type": "alpha"
                },
                {
                    "text": "Episode duration (seconds)",
                    "template": "{text} seconds episode duration",
                    "type": "number"
                },
                {
                    "text": "Episode duration (minutes)",
                    "template": "{text} minutes episode duration",
                    "type": "number"
                },
                {
                    "text": "Episode duration (hours)",
                    "template": "{text} hours episode duration",
                    "type": "number"
                },
                {
                    "text": "Episode duration (days)",
                    "template": "{text} days episode duration",
                    "type": "number"
                }
            ]
        },
        {
            "text": "Pertinent positives\/negatives",
            "template": "Pertinent positives\/negatives include: {children}.",
            "children": [
                {
                    "text": "HEENT symptoms",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "rhinorrhea",
                            "template": "rhinorrhea",
                            "type": "plus-minus"
                        },
                        {
                            "text": "sinus congestion",
                            "template": "sinus congestion",
                            "type": "plus-minus"
                        },
                        {
                            "text": "vision change",
                            "template": "vision change",
                            "type": "plus-minus"
                        },
                        {
                            "text": "hearing change",
                            "template": "hearing change",
                            "type": "plus-minus"
                        },
                        {
                            "text": "diplopia",
                            "template": "diplopia",
                            "type": "plus-minus"
                        },
                        {
                            "text": "photophobia",
                            "template": "photophobia",
                            "type": "plus-minus"
                        },
                        {
                            "text": "sonophobia",
                            "template": "sonophobia",
                            "type": "plus-minus"
                        },
                        {
                            "text": "left ear fullness",
                            "template": "left ear fullness",
                            "type": "plus-minus"
                        },
                        {
                            "text": "right ear fullness",
                            "template": "right ear fullness",
                            "type": "plus-minus"
                        },
                        {
                            "text": "left ear pain",
                            "template": "left ear pain",
                            "type": "plus-minus"
                        },
                        {
                            "text": "right ear pain",
                            "template": "right ear pain",
                            "type": "plus-minus"
                        },
                        {
                            "text": "tinnitus",
                            "template": "tinnitus",
                            "type": "plus-minus"
                        }
                    ]
                },
                {
                    "text": "Neurological",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "headaches",
                            "template": "headaches",
                            "type": "plus-minus"
                        },
                        {
                            "text": "difficulty walking",
                            "template": "difficulty walking",
                            "type": "plus-minus"
                        },
                        {
                            "text": "ataxia",
                            "template": "ataxia",
                            "type": "plus-minus"
                        },
                        {
                            "text": "dysarthria",
                            "template": "dysarthria",
                            "type": "plus-minus"
                        },
                        {
                            "text": "generalized weakness",
                            "template": "generalized weakness",
                            "type": "plus-minus"
                        },
                        {
                            "text": "focal weakness",
                            "template": "focal weakness",
                            "type": "plus-minus"
                        },
                        {
                            "text": "numbness",
                            "template": "numbness",
                            "type": "plus-minus"
                        },
                        {
                            "text": "loss of consciousness",
                            "template": "loss of consciousness",
                            "type": "plus-minus"
                        },
                        {
                            "text": "drop attacks",
                            "template": "drop attacks",
                            "type": "plus-minus"
                        },
                        {
                            "text": "visual aura",
                            "template": "visual aura",
                            "type": "plus-minus"
                        }
                    ]
                },
                {
                    "text": "nausea",
                    "template": "{children}",
                    "type": "plus-minus"
                },
                {
                    "text": "vomiting",
                    "template": "vomiting",
                    "type": "plus-minus"
                },
                {
                    "text": "fever",
                    "template": "fever",
                    "type": "plus-minus"
                },
                {
                    "text": "dysphagia",
                    "template": "dysphagia",
                    "type": "plus-minus"
                },
                {
                    "text": "palpitations",
                    "template": "palpitations",
                    "type": "plus-minus"
                },
                {
                    "text": "focal neck pain",
                    "template": "focal neck pain",
                    "type": "plus-minus"
                },
                {
                    "text": "shortness of breath",
                    "template": "shortness of breath",
                    "type": "plus-minus"
                },
                {
                    "text": "sweating",
                    "template": "sweating",
                    "type": "plus-minus"
                },
                {
                    "text": "anxiety",
                    "template": "anxiety",
                    "type": "plus-minus"
                },
                {
                    "text": "panic",
                    "template": "panic",
                    "type": "plus-minus"
                },
                {
                    "text": "other pertinent sx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Severity",
            "template": "Symptom severity described as {children}.",
            "children": [
                {
                    "text": "mild",
                    "template": "mild"
                },
                {
                    "text": "moderate",
                    "template": "moderate"
                },
                {
                    "text": "severe",
                    "template": "severe"
                },
                {
                    "text": "incapacitating",
                    "template": "incapacitating"
                },
                {
                    "text": "interfering with daily activities",
                    "template": "interfering with daily activities"
                },
                {
                    "text": "symptom severity (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Exacerbating\/Alleviating factors",
            "template": "Patient reports that {children}.",
            "children": [
                {
                    "text": "Position change",
                    "template": "position change {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": "unknown effect on sx",
                            "template": "has unknown effect on sx"
                        }
                    ]
                },
                {
                    "text": "Movement",
                    "template": "movement {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": "unknown effect on sx",
                            "template": "has unknowne effect on sx"
                        }
                    ]
                },
                {
                    "text": "Turning head",
                    "template": "turning head {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": "unknown effect on sx",
                            "template": "has unknown effect on sx"
                        }
                    ]
                },
                {
                    "text": "Holding head still",
                    "template": "holding the head still {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": "unknown effect on sx",
                            "template": "has unknown effect on sx"
                        }
                    ]
                },
                {
                    "text": "Extending neck",
                    "template": "extending the neck {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": "unknown effect on sx",
                            "template": "has unknown effect on sx"
                        }
                    ]
                },
                {
                    "text": "Rolling over in bed",
                    "template": "rolling over in bed {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": "unknown effect on sx",
                            "template": "has unknown effect on sx"
                        }
                    ]
                },
                {
                    "text": "Bending down",
                    "template": "bending 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": "unknown effect on sx",
                            "template": "has unknown effect on sx"
                        }
                    ]
                },
                {
                    "text": "Sitting down",
                    "template": "sitting 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": "unknown effect on sx",
                            "template": "has unknown effect on sx"
                        }
                    ]
                },
                {
                    "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": "unknown effect on sx",
                            "template": "has unknown effect on sx"
                        }
                    ]
                },
                {
                    "text": "Rising from lying\/sitting",
                    "template": "rising from lying or sitting {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": "unknown effect on sx",
                            "template": "has unknown effect on sx"
                        }
                    ]
                },
                {
                    "text": "Physical exertion",
                    "template": "physical exertion {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": "unknown effect on sx",
                            "template": "has unknown effect on sx"
                        }
                    ]
                },
                {
                    "text": "Weight lifting",
                    "template": "weight lifting {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": "Bowel movements",
                    "template": "bowel movements {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": "unknown effect on six",
                            "template": "have unknown effect on sx"
                        }
                    ]
                },
                {
                    "text": "Visual fixation",
                    "template": "visual fixation {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": "Coughing",
                    "template": "coughing {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": "unknown effect on sx",
                            "template": "has unknown effect on sx"
                        }
                    ]
                },
                {
                    "text": "Sneezing",
                    "template": "sneezing {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": "unknown effect on sx",
                            "template": "has unknown effect on sx"
                        }
                    ]
                },
                {
                    "text": "Loud noises",
                    "template": "loud noises {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": "unknown effect on sx",
                            "template": "have unknown effect on sx"
                        }
                    ]
                },
                {
                    "text": "OTC meds",
                    "template": "OTC meds {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": "Rx meds",
                    "template": "Rx meds {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 contributing factors (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Medical Hx specific to visit",
            "template": "Medical Hx specific to visit includes: {children}.",
            "children": [
                {
                    "text": "recent head trauma",
                    "template": "recent head trauma",
                    "type": "plus-minus"
                },
                {
                    "text": "previous middle ear surgery",
                    "template": "previous middle ear surgery",
                    "type": "plus-minus"
                },
                {
                    "text": "migraines",
                    "template": "migraines",
                    "type": "plus-minus"
                },
                {
                    "text": "recent URI",
                    "template": "recent URI",
                    "type": "plus-minus"
                },
                {
                    "text": "anxiety",
                    "template": "anxiety",
                    "type": "plus-minus"
                },
                {
                    "text": "depression",
                    "template": "depression",
                    "type": "plus-minus"
                },
                {
                    "text": "TIA",
                    "template": "TIA",
                    "type": "plus-minus"
                },
                {
                    "text": "stroke",
                    "template": "stroke",
                    "type": "plus-minus"
                },
                {
                    "text": "hypertension",
                    "template": "hypertension",
                    "type": "plus-minus"
                },
                {
                    "text": "diabetes type 1",
                    "template": "diabetes type 1",
                    "type": "plus-minus"
                },
                {
                    "text": "diabetes type 2",
                    "template": "diabetes type 2",
                    "type": "plus-minus"
                },
                {
                    "text": "CAD",
                    "template": "CAD",
                    "type": "plus-minus"
                },
                {
                    "text": "multiple sclerosis",
                    "template": "multiple sclerosis",
                    "type": "plus-minus"
                },
                {
                    "text": "seizure disorder",
                    "template": "seizure disorder",
                    "type": "plus-minus"
                },
                {
                    "text": "recent cisplatin use",
                    "template": "recent cisplatin use",
                    "type": "plus-minus"
                },
                {
                    "text": "recent aminoglycoside use",
                    "template": "recent aminoglycoside use",
                    "type": "plus-minus"
                },
                {
                    "text": "family Hx vertigo",
                    "template": "family Hx vertigo",
                    "type": "plus-minus"
                },
                {
                    "text": "other medical Hx (specify)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Lifestyle\/Environment factors",
            "template": "Lifestyle\/Environmental factors include {children}.",
            "children": [
                {
                    "text": "recent SCUBA diving",
                    "template": "recent SCUBA diving",
                    "type": "plus-minus"
                },
                {
                    "text": "alcohol abuse",
                    "template": "alcohol abuse",
                    "type": "plus-minus"
                },
                {
                    "text": "drug use",
                    "template": "drug use",
                    "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"
                }
            ]
        }
    ]
}