{
    "section": "subjective",
    "templateSet": "Sinusitis",
    "templates": [
        {
            "text": "Reason for visit",
            "template": "Patient presents for {children}.",
            "children": [
                {
                    "text": "new onset symptom evaluation",
                    "template": "evaluation of new onset symptoms"
                },
                {
                    "text": "initial evaluation of sinus symptoms",
                    "template": "initial evaluation of sinus symptoms"
                },
                {
                    "text": "follow-up evaluation of sinusitis",
                    "template": "follow-up evaluation of sinusitis"
                },
                {
                    "text": "ongoing management of sinusitis",
                    "template": "ongoing management of sinusitis"
                },
                {
                    "text": "Visit reason (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Onset\/Time course",
            "template": "Condition {children}.",
            "children": [
                {
                    "text": "acute onset (new condition)",
                    "template": "is reported to have developed acutely"
                },
                {
                    "text": "chronic and ongoing condition",
                    "template": "is chronic and ongoing"
                },
                {
                    "text": "acutely worse (chronic condition)",
                    "template": "severity is reported to have acutely worsened"
                },
                {
                    "text": "progressively worsened",
                    "template": "is reported to have progressively worsened"
                },
                {
                    "text": "Duration (days)",
                    "template": "is reported as having been present for {text} days",
                    "type": "number"
                },
                {
                    "text": "Duration (weeks)",
                    "template": "is reported as having been present for {text} weeks",
                    "type": "number"
                },
                {
                    "text": "Duration (months)",
                    "template": "is reported as having been present for {text} months",
                    "type": "number"
                },
                {
                    "text": "Duration (describe)",
                    "template": "is reported as having been present for {text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "T max (Fahrenheit)",
            "template": "T max: {text} F.",
            "type": "number"
        },
        {
            "text": "Symptoms",
            "template": "Patient reports the presence\/absence of the following Hx\/sx related to the current\n                        visit: {children}.\n                    ",
            "children": [
                {
                    "text": "fever",
                    "template": "fever",
                    "type": "plus-minus"
                },
                {
                    "text": "nasal congestion",
                    "template": "nasal congestion",
                    "type": "plus-minus"
                },
                {
                    "text": "rhinorrhea",
                    "template": "rhinorrhea",
                    "type": "plus-minus"
                },
                {
                    "text": "sneezing",
                    "template": "sneezing",
                    "type": "plus-minus"
                },
                {
                    "text": "itchy\/watery eyes",
                    "template": "itchy\/watery eyes",
                    "type": "plus-minus"
                },
                {
                    "text": "R facial pain",
                    "template": "right facial pain",
                    "type": "plus-minus"
                },
                {
                    "text": "L facial pain",
                    "template": "left facial pain",
                    "type": "plus-minus"
                },
                {
                    "text": "headache",
                    "template": "headache",
                    "type": "plus-minus"
                },
                {
                    "text": "sore throat",
                    "template": "sore throat",
                    "type": "plus-minus"
                },
                {
                    "text": "non-productive cough",
                    "template": "non-productive cough",
                    "type": "plus-minus"
                },
                {
                    "text": "productive cough",
                    "template": "productive cough",
                    "type": "plus-minus"
                },
                {
                    "text": "other (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Pertinent positives\/negatives",
            "template": "{children}",
            "children": [
                {
                    "text": "R upper toothache",
                    "template": "R upper toothache",
                    "type": "plus-minus"
                },
                {
                    "text": "L upper tooth ache",
                    "template": "L upper tooth ache",
                    "type": "plus-minus"
                },
                {
                    "text": "R facial pain",
                    "template": "right facial pain",
                    "type": "plus-minus"
                },
                {
                    "text": "L facial pain",
                    "template": "left facial pain",
                    "type": "plus-minus"
                },
                {
                    "text": "purulent nasal discharge",
                    "template": "purulent nasal discharge",
                    "type": "plus-minus"
                },
                {
                    "text": "clear nasal discharge",
                    "template": "clear nasal discharge",
                    "type": "plus-minus"
                },
                {
                    "text": "non-productive cough",
                    "template": "non-productive cough",
                    "type": "plus-minus"
                },
                {
                    "text": "productive cough",
                    "template": "productive cough",
                    "type": "plus-minus"
                },
                {
                    "text": "purulent sputum",
                    "template": "purulent sputum",
                    "type": "plus-minus"
                },
                {
                    "text": "halitosis",
                    "template": "halitosis",
                    "type": "plus-minus"
                },
                {
                    "text": "difficulty swallowing",
                    "template": "difficulty swallowing",
                    "type": "plus-minus"
                },
                {
                    "text": "itchy\/watery eyes",
                    "template": "itchy\/watery eyes",
                    "type": "plus-minus"
                },
                {
                    "text": "pain behind the eyes",
                    "template": "pain behind the eyes",
                    "type": "plus-minus"
                },
                {
                    "text": "photophobia",
                    "template": "photophobia",
                    "type": "plus-minus"
                },
                {
                    "text": "hoarseness",
                    "template": "hoarseness",
                    "type": "plus-minus"
                },
                {
                    "text": "wheezing",
                    "template": "wheezing",
                    "type": "plus-minus"
                },
                {
                    "text": "dyspnea\/ SOB",
                    "template": "dyspnea\/shortness of breath",
                    "type": "plus-minus"
                },
                {
                    "text": "pleuritic chest pain",
                    "template": "pleuritic chest pain",
                    "type": "plus-minus"
                },
                {
                    "text": "post-tussive emesis",
                    "template": "post-tussive emesis",
                    "type": "plus-minus"
                },
                {
                    "text": "abdominal pain",
                    "template": "abdominal pain",
                    "type": "plus-minus"
                },
                {
                    "text": "diarrhea",
                    "template": "diarrhea",
                    "type": "plus-minus"
                },
                {
                    "text": "myalgia",
                    "template": "myalgia",
                    "type": "plus-minus"
                },
                {
                    "text": "fatigue\/malaise",
                    "template": "fatigue\/malaise",
                    "type": "plus-minus"
                },
                {
                    "text": "rash",
                    "template": "rash",
                    "type": "plus-minus"
                },
                {
                    "text": "Other pertinent sx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Medical Hx specific to visit",
            "template": "Medical history includes {children}.",
            "children": [
                {
                    "text": "Recent upper respiratory infection",
                    "template": "Recent upper respiratory infection",
                    "type": "plus-minus"
                },
                {
                    "text": "hayfever\/resp. allergies",
                    "template": "hayfever\/resp. allergies",
                    "type": "plus-minus"
                },
                {
                    "text": "asthma\/reactive airways dz",
                    "template": "asthma\/reactive airways dz",
                    "type": "plus-minus"
                },
                {
                    "text": "COPD",
                    "template": "COPD",
                    "type": "plus-minus"
                },
                {
                    "text": "current pregnancy",
                    "template": "current pregnancy",
                    "type": "plus-minus"
                },
                {
                    "text": "diabetes mellitus",
                    "template": "diabetes mellitus",
                    "type": "plus-minus"
                },
                {
                    "text": "immunosuppressive agent use",
                    "template": "immunosuppressive agent use",
                    "type": "plus-minus"
                },
                {
                    "text": "s\/p splenectomy",
                    "template": "s\/p splenectomy",
                    "type": "plus-minus"
                },
                {
                    "text": "HIV",
                    "template": "HIV",
                    "type": "plus-minus"
                },
                {
                    "text": "malignancy",
                    "template": "malignancy",
                    "type": "plus-minus"
                },
                {
                    "text": "hospitalized w\/in last year",
                    "template": "hospitalized w\/in last year",
                    "type": "plus-minus"
                },
                {
                    "text": "heart failure",
                    "template": "heart failure",
                    "type": "plus-minus"
                },
                {
                    "text": "Recent travel",
                    "template": "recent travel: {text}",
                    "type": "alpha"
                },
                {
                    "text": "Household contact",
                    "template": "household contact: {text}",
                    "type": "alpha"
                },
                {
                    "text": "Close contact",
                    "template": "close contact: {text}",
                    "type": "alpha"
                },
                {
                    "text": "Other medical Hx (describe)",
                    "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"
                }
            ]
        },
        {
            "text": "Immunizations",
            "template": "Immunization Hx: {children}",
            "children": [
                {
                    "text": "flu vaccine received this season",
                    "template": "flu vaccine received this season",
                    "type": "plus-minus"
                },
                {
                    "text": "pneumococcal vaccine Hx",
                    "template": "pneumococcal vaccine Hx",
                    "type": "plus-minus"
                },
                {
                    "text": "meningococcal vaccine Hx",
                    "template": "meningococcal vaccine Hx",
                    "type": "plus-minus"
                },
                {
                    "text": "Pertussis vaccine",
                    "template": "pertussis vaccine is {children}",
                    "children": [
                        {
                            "text": "up to date",
                            "template": "up to date"
                        },
                        {
                            "text": "not up to date",
                            "template": "not up to date"
                        }
                    ]
                },
                {
                    "text": "Other immunizations (specify)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        }
    ]
}