{
    "section": "subjective",
    "templateSet": "Conjunctivitis",
    "templates": [
        {
            "text": "Reason for visit",
            "template": "Patient presents {children}.",
            "children": [
                {
                    "text": "new onset conjunctivitis sx evaluation",
                    "template": "for evaluation of new onset conjunctivitis symptoms {children}",
                    "children": [
                        {
                            "text": "left eye",
                            "template": "in left eye"
                        },
                        {
                            "text": "right eye",
                            "template": "in right eye"
                        },
                        {
                            "text": "both eyes",
                            "template": "in both eyes"
                        }
                    ]
                },
                {
                    "text": "initial evaluation of conjunctivitis sx",
                    "template": "for initial evaluation of conjunctivitis sx",
                    "children": [
                        {
                            "text": "left eye",
                            "template": "in left eye"
                        },
                        {
                            "text": "right eye",
                            "template": "in right eye"
                        },
                        {
                            "text": "both eyes",
                            "template": "in both eyes"
                        }
                    ]
                },
                {
                    "text": "follow-up conjunctivitis",
                    "template": "for follow-up of conjunctivitis",
                    "children": [
                        {
                            "text": "left eye",
                            "template": "in left eye"
                        },
                        {
                            "text": "right eye",
                            "template": "in right eye"
                        },
                        {
                            "text": "both eyes",
                            "template": "in both eyes"
                        }
                    ]
                },
                {
                    "text": "ongoing conjunctivitis management",
                    "template": "for ongoing management of conjunctivitis",
                    "children": [
                        {
                            "text": "left eye",
                            "template": "in left eye"
                        },
                        {
                            "text": "right eye",
                            "template": "in right eye"
                        },
                        {
                            "text": "both eyes",
                            "template": "in both eyes"
                        }
                    ]
                },
                {
                    "text": "Visit reason (describe)",
                    "template": "for {text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Onset\/Time course",
            "template": "Sx onset and time course: Patient reports {children}.",
            "children": [
                {
                    "text": "acute onset",
                    "template": "acute onset",
                    "type": "plus-minus"
                },
                {
                    "text": "gradual onset",
                    "template": "gradual onset",
                    "type": "plus-minus"
                },
                {
                    "text": "recurrent",
                    "template": "recurrent condition",
                    "type": "plus-minus"
                },
                {
                    "text": "chronic",
                    "template": "chronic condition",
                    "type": "plus-minus"
                },
                {
                    "text": "Hours of sx(specify)",
                    "template": "{text} hours sx",
                    "type": "number"
                },
                {
                    "text": "Days of symptoms (specify)",
                    "template": "{text} days sx",
                    "type": "number"
                },
                {
                    "text": "Weeks of symptoms (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": "Symptoms (eyes)",
            "template": "Patient reports the presence\/absence of the following eye symptoms related to the current\n                        visit: {children}.\n                    ",
            "children": [
                {
                    "text": "none",
                    "template": "no sx"
                },
                {
                    "text": "redness",
                    "template": "redness",
                    "type": "plus-minus"
                },
                {
                    "text": "itching",
                    "template": "itching",
                    "type": "plus-minus"
                },
                {
                    "text": "stinging",
                    "template": "stinging",
                    "type": "plus-minus"
                },
                {
                    "text": "burning",
                    "template": "burning",
                    "type": "plus-minus"
                },
                {
                    "text": "eye pain",
                    "template": "eye pain",
                    "type": "plus-minus"
                },
                {
                    "text": "photophobia",
                    "template": "photophobia",
                    "type": "plus-minus"
                },
                {
                    "text": "visual difficulty",
                    "template": "visual difficulty",
                    "type": "plus-minus"
                },
                {
                    "text": "ropey discharge",
                    "template": "ropey discharge",
                    "type": "plus-minus"
                },
                {
                    "text": "mucoid discharge",
                    "template": "mucoid discharge",
                    "type": "plus-minus"
                },
                {
                    "text": "watery discharge",
                    "template": "watery discharge",
                    "type": "plus-minus"
                },
                {
                    "text": "gritty sensation",
                    "template": "gritty sensation",
                    "type": "plus-minus"
                },
                {
                    "text": "foreign body sensation",
                    "template": "foreign body sensation",
                    "type": "plus-minus"
                },
                {
                    "text": "swollen eyelids",
                    "template": "swollen eyelids",
                    "type": "plus-minus"
                },
                {
                    "text": "crusty eyelids",
                    "template": "crusty eyelids",
                    "type": "plus-minus"
                },
                {
                    "text": "lids stuck closed in a.m.",
                    "template": "lids stuck closed upon awakening",
                    "type": "plus-minus"
                },
                {
                    "text": "other sx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Pertinent positives\/negatives",
            "template": "Pertinent positive\/negative symptoms include: {children}.",
            "children": [
                {
                    "text": "recent trauma to eye",
                    "template": "recent trauma to eye",
                    "type": "plus-minus"
                },
                {
                    "text": "General\/Constitutional",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "fever",
                            "template": "fever",
                            "type": "plus-minus"
                        },
                        {
                            "text": "chills",
                            "template": "chills",
                            "type": "plus-minus"
                        },
                        {
                            "text": "fatigue",
                            "template": "fatigue",
                            "type": "plus-minus"
                        }
                    ]
                },
                {
                    "text": "HEENT",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "sneezing",
                            "template": "sneezing",
                            "type": "plus-minus"
                        },
                        {
                            "text": "rhinorrhea",
                            "template": "rhinorrhea",
                            "type": "plus-minus"
                        },
                        {
                            "text": "nose itching",
                            "template": "nose itching",
                            "type": "plus-minus"
                        },
                        {
                            "text": "nasal congestion",
                            "template": "nasal congestion",
                            "type": "plus-minus"
                        },
                        {
                            "text": "nasal discharge",
                            "template": "nasal discharge",
                            "type": "plus-minus"
                        },
                        {
                            "text": "epistaxis",
                            "template": "epistaxis",
                            "type": "plus-minus"
                        },
                        {
                            "text": "post nasal drip",
                            "template": "post nasal drip",
                            "type": "plus-minus"
                        },
                        {
                            "text": "decreased sense of smell",
                            "template": "decreased sense of smell",
                            "type": "plus-minus"
                        },
                        {
                            "text": "decreased sense of taste",
                            "template": "decreased sense of taste",
                            "type": "plus-minus"
                        },
                        {
                            "text": "sore throat",
                            "template": "sore throat",
                            "type": "plus-minus"
                        },
                        {
                            "text": "frequent need to clear throat",
                            "template": "frequent need to clear throat",
                            "type": "plus-minus"
                        }
                    ]
                },
                {
                    "text": "Respiratory",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "dyspnea",
                            "template": "dyspnea",
                            "type": "plus-minus"
                        },
                        {
                            "text": "cough",
                            "template": "cough",
                            "type": "plus-minus"
                        },
                        {
                            "text": "wheeze",
                            "template": "wheeze",
                            "type": "plus-minus"
                        },
                        {
                            "text": "clear sputum",
                            "template": "clear sputum",
                            "type": "plus-minus"
                        },
                        {
                            "text": "purulent sputum",
                            "template": "purulent sputum",
                            "type": "plus-minus"
                        },
                        {
                            "text": "blood-tinged sputum",
                            "template": "blood-tinged sputum",
                            "type": "plus-minus"
                        }
                    ]
                },
                {
                    "text": "Dermatologic",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "itching",
                            "template": "skin itching",
                            "type": "plus-minus"
                        },
                        {
                            "text": "hives",
                            "template": "hives",
                            "type": "plus-minus"
                        },
                        {
                            "text": "rash",
                            "template": "rash",
                            "type": "plus-minus"
                        }
                    ]
                },
                {
                    "text": "Genitourinary",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "vaginal discharge",
                            "template": "vaginal discharge",
                            "type": "plus-minus"
                        },
                        {
                            "text": "urethral discharge",
                            "template": "urethral discharge",
                            "type": "plus-minus"
                        }
                    ]
                },
                {
                    "text": "other pertinent sx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Exacerbating\/Alleviating factors",
            "template": "Patient reports that {children}.",
            "children": [
                {
                    "text": "Bright lights",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "worsen sx",
                            "template": "bright lights worsen sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "bright lights have no effect on sx"
                        },
                        {
                            "text": "effect has not been observed",
                            "template": "any effect of bright lights has not been observed"
                        }
                    ]
                },
                {
                    "text": "Allergies",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "worsen sx",
                            "template": "allergies worsen sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "allergies have no effect on sx"
                        },
                        {
                            "text": "effect has not been observed",
                            "template": "any effect of allergies has not been observed"
                        }
                    ]
                },
                {
                    "text": "Infection",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "worsens sx",
                            "template": "infection worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "infection has no effect on sx"
                        },
                        {
                            "text": "effect has not been observed",
                            "template": "any effect of infection has not been observed"
                        }
                    ]
                },
                {
                    "text": "Medications",
                    "template": "medications {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": "Warm, moist compresses",
                    "template": "warm, moist compresses {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": "Artificial tears",
                    "template": "artificial tears {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": "OTC eye medications",
                    "template": "OTC eye medications {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": "Prescription eye medications",
                    "template": "prescription eye medications {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": "Tx response",
            "template": "Treatment effects: {children}.",
            "children": [
                {
                    "text": "not on treatment",
                    "template": "not on treatment"
                },
                {
                    "text": "adherent to current tx",
                    "template": "adherent to current tx"
                },
                {
                    "text": "nonadherent to current tx",
                    "template": "nonadherent to current tx"
                },
                {
                    "text": "Treatment response",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "resolved with treatment",
                            "template": "resolved with treatment"
                        },
                        {
                            "text": "improving on treatment",
                            "template": "improving on treatment"
                        },
                        {
                            "text": "unchanged on treatment",
                            "template": "unchanged on treatment"
                        },
                        {
                            "text": "exacerbated despite treatment",
                            "template": "exacerbated despite treatment"
                        }
                    ]
                },
                {
                    "text": "Treatment response (describe)",
                    "template": "tx response {text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Medical Hx specific to visit",
            "template": "Medical Hx specific to visit includes: {children}.",
            "children": [
                {
                    "text": "allergic rhinitis",
                    "template": "allergic rhinitis",
                    "type": "plus-minus"
                },
                {
                    "text": "allergies",
                    "template": "allergies",
                    "type": "plus-minus"
                },
                {
                    "text": "hay fever",
                    "template": "hay fever",
                    "type": "plus-minus"
                },
                {
                    "text": "asthma",
                    "template": "asthma",
                    "type": "plus-minus"
                },
                {
                    "text": "sinusitis",
                    "template": "sinusitis",
                    "type": "plus-minus"
                },
                {
                    "text": "otitis media",
                    "template": "otitis media",
                    "type": "plus-minus"
                },
                {
                    "text": "atopic dermatitis",
                    "template": "atopic dermatitis",
                    "type": "plus-minus"
                },
                {
                    "text": "Hx STD",
                    "template": "Hx of STD",
                    "type": "plus-minus"
                },
                {
                    "text": "Hx conjunctivitis",
                    "template": "Hx of conjunctivitis",
                    "type": "plus-minus"
                },
                {
                    "text": "other medical Hx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Lifestyle\/Environment factors",
            "template": "Lifestyle\/Environment factors include: {children}.",
            "children": [
                {
                    "text": "sexually active",
                    "template": "sexually active",
                    "type": "plus-minus"
                },
                {
                    "text": "contact w\/ person w\/ conjunctivitis",
                    "template": "contact w\/person w\/ conjunctivitis",
                    "type": "plus-minus"
                },
                {
                    "text": "contact w\/ person w\/ STD",
                    "template": "contact w\/ person w\/ STD",
                    "type": "plus-minus"
                },
                {
                    "text": "eye trauma",
                    "template": "hx of recent eye trauma",
                    "type": "plus-minus"
                },
                {
                    "text": "new facial products",
                    "template": "new facial products",
                    "type": "plus-minus"
                },
                {
                    "text": "allergen exposure",
                    "template": "exposure to allergens",
                    "type": "plus-minus"
                },
                {
                    "text": "chemical exposure",
                    "template": "exposure to chemicals",
                    "type": "plus-minus"
                },
                {
                    "text": "dust",
                    "template": "exposure to dust",
                    "type": "plus-minus"
                },
                {
                    "text": "wind",
                    "template": "exposure to wind",
                    "type": "plus-minus"
                },
                {
                    "text": "welding",
                    "template": "exposure to welding",
                    "type": "plus-minus"
                },
                {
                    "text": "swimming pool",
                    "template": "recent swimming pool(s) use",
                    "type": "plus-minus"
                },
                {
                    "text": "eye medications",
                    "template": "use of eye medications",
                    "type": "plus-minus"
                },
                {
                    "text": "uses contact lenses",
                    "template": "uses contact lenses",
                    "type": "plus-minus"
                },
                {
                    "text": "occupation exposure (describe)",
                    "template": "occupational exposure includes {text}",
                    "type": "alpha"
                },
                {
                    "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"
                }
            ]
        },
        {
            "text": "Family Hx specific to visit",
            "template": "Family Hx specific to visit includes: {children}.",
            "children": [
                {
                    "text": "asthma",
                    "template": "asthma",
                    "type": "plus-minus"
                },
                {
                    "text": "allergic rhinitis",
                    "template": "allergic rhinitis",
                    "type": "plus-minus"
                },
                {
                    "text": "atopic dermatitis",
                    "template": "atopic dermatitis",
                    "type": "plus-minus"
                },
                {
                    "text": "chronic sinus problems",
                    "template": "chronic sinus problems",
                    "type": "plus-minus"
                },
                {
                    "text": "sinus infections",
                    "template": "sinus infections",
                    "type": "plus-minus"
                },
                {
                    "text": "recurrent bronchitis",
                    "template": "recurrent bronchitis",
                    "type": "plus-minus"
                },
                {
                    "text": "other family Hx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        }
    ]
}