{
    "section": "plan",
    "templateSet": "Gynecology Annual Visit",
    "templates": [
        {
            "text": "Ordered Labs",
            "template": "Ordered Labs {children}",
            "children": [
                {
                    "text": "Blood chemistry\/Hematology",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "CBC",
                            "template": "CBC"
                        },
                        {
                            "text": "CBC w\/ auto diff",
                            "template": "CBC w\/ auto diff"
                        },
                        {
                            "text": "Metabolic panel, basic (BMP), serum",
                            "template": "Metabolic panel, basic (BMP), serum"
                        },
                        {
                            "text": "Metabolic panel, comprehensive (CMP), serum",
                            "template": "Metabolic panel, comprehensive (CMP), serum"
                        },
                        {
                            "text": "Lipid panel",
                            "template": "Lipid panel"
                        },
                        {
                            "text": "Hepatic function panel (LFTs)",
                            "template": "Hepatic function panel (LFTs)"
                        },
                        {
                            "text": "Hepatitis screening panel",
                            "template": "Hepatitis screening panel"
                        },
                        {
                            "text": "Magnesium, serum",
                            "template": "Magnesium, serum"
                        },
                        {
                            "text": "Glucose, fasting, plasma",
                            "template": "Glucose, fasting, plasma"
                        },
                        {
                            "text": "Glucose, fingerstick",
                            "template": "Glucose, fingerstick"
                        },
                        {
                            "text": "Hemoglobin A1c (HbA1c), blood",
                            "template": "Hemoglobin A1c (HbA1c), blood"
                        },
                        {
                            "text": "TSH (thyroid-stimulating hormone), serum",
                            "template": "TSH (thyroid-stimulating hormone), serum"
                        },
                        {
                            "text": "Thyroxine (T4), free, serum",
                            "template": "Thyroxine (T4), free, serum"
                        },
                        {
                            "text": "PT (prothrombin time)",
                            "template": "PT (prothrombin time)"
                        },
                        {
                            "text": "PT\/INR",
                            "template": "PT\/INR"
                        },
                        {
                            "text": "Uric acid, serum",
                            "template": "Uric acid, serum"
                        },
                        {
                            "text": "Erythrocyte sedimentation rate (ESR)",
                            "template": "Erythrocyte sedimentation rate (ESR)"
                        },
                        {
                            "text": "C-reactive protein, high-sensitivity (hs-CRP), serum",
                            "template": "C-reactive protein, high-sensitivity (hs-CRP), serum"
                        },
                        {
                            "text": "Creatinine kinase (CK), serum",
                            "template": "Creatinine kinase (CK), serum"
                        },
                        {
                            "text": "Vitamin D, 25-OH, serum",
                            "template": "Vitamin D, 25-OH, serum"
                        },
                        {
                            "text": "Parathyroid hormone (PTH), serum",
                            "template": "Parathyroid hormone (PTH), serum"
                        },
                        {
                            "text": "HIV-1+HIV-2 antibody screen, serum",
                            "template": "HIV-1+HIV-2 antibody screen, serum"
                        },
                        {
                            "text": "CD4 T-cell count, blood",
                            "template": "CD4 T-cell count, blood"
                        },
                        {
                            "text": "RPR (rapid plasma reagin), serum",
                            "template": "RPR (rapid plasma reagin), serum"
                        },
                        {
                            "text": "FTA-ABS (fluorescent treponemal antibody absorption test)",
                            "template": "FTA-ABS (fluorescent treponemal antibody absorption test)"
                        },
                        {
                            "text": "Beta-hCG, qualitative, serum",
                            "template": "Beta-hCG, qualitative, serum"
                        },
                        {
                            "text": "Follicle stimulating hormone (FSH)",
                            "template": "Follicle stimulating hormone (FSH)"
                        },
                        {
                            "text": "Luteinizing hormone (LH), serum",
                            "template": "Luteinizing hormone (LH), serum"
                        }
                    ]
                },
                {
                    "text": "Urine tests",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Urinalysis, complete (with micro)",
                            "template": "Urinalysis, complete (with micro)"
                        },
                        {
                            "text": "Urine dipstick",
                            "template": "Urine dipstick"
                        },
                        {
                            "text": "Culture, urine, bacterial",
                            "template": "Culture, urine, bacterial"
                        },
                        {
                            "text": "Microalbumin, random, urine",
                            "template": "Microalbumin, random, urine"
                        },
                        {
                            "text": "Beta-hCG, qualitative, urine",
                            "template": "Beta-hCG, qualitative, urine"
                        },
                        {
                            "text": "Chlamydia trachomatis, nucleic acid amplification, urine",
                            "template": "Chlamydia trachomatis, nucleic acid amplification, urine"
                        },
                        {
                            "text": "Neisseria gonorrhoeae (GC), nucleic acid amplification, urine",
                            "template": "Neisseria gonorrhoeae (GC), nucleic acid amplification, urine"
                        }
                    ]
                },
                {
                    "text": "Microbiology\/Other Samples",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Fecal occult blood test (FOBT)",
                            "template": "Fecal occult blood test (FOBT)"
                        },
                        {
                            "text": "Trichomonas wet mount, vaginal",
                            "template": "Trichomonas wet mount, vaginal"
                        },
                        {
                            "text": "Gram stain, vaginal secretions",
                            "template": "Gram stain, vaginal secretions"
                        },
                        {
                            "text": "pH Test",
                            "template": "pH Test"
                        },
                        {
                            "text": "KOH Whiff test",
                            "template": "KOH Whiff test"
                        },
                        {
                            "text": "Pap Smear",
                            "template": "Pap Smear"
                        },
                        {
                            "text": "Neisseria gonorrhoeae (GC), nucleic acid amplification, vaginal swab",
                            "template": "Neisseria gonorrhoeae (GC), nucleic acid amplification, vaginal swab"
                        },
                        {
                            "text": "Chlamydia trachomatis nucleic acid amplification, vaginal",
                            "template": "Chlamydia trachomatis nucleic acid amplification, vaginal"
                        },
                        {
                            "text": "Culture, Chlamydia trachomatis (CT), vaginal",
                            "template": "Culture, Chlamydia trachomatis (CT), vaginal"
                        },
                        {
                            "text": "Culture, Neisseria gonorrhoeae (GC), vaginal",
                            "template": "Culture, Neisseria gonorrhoeae (GC), vaginal"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Ordered Imaging",
            "template": "Ordered Imaging{children}",
            "children": [
                {
                    "text": "CT",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "CT abdomen and pelvis w\/ contrast",
                            "template": "CT abdomen and pelvis w\/ contrast"
                        },
                        {
                            "text": "CT abdomen and pelvis w\/o contrast",
                            "template": "CT abdomen and pelvis w\/o contrast"
                        }
                    ]
                },
                {
                    "text": "Mammogram",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Mammogram, diagnostic",
                            "template": "Mammogram, diagnostic"
                        },
                        {
                            "text": "Mammogram, screening",
                            "template": "Mammogram, screening"
                        }
                    ]
                },
                {
                    "text": "MRI",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "MRI pelvis w\/ contrast",
                            "template": "MRI pelvis w\/ contrast"
                        },
                        {
                            "text": "MRI pelvis w\/o contrast",
                            "template": "MRI pelvis w\/o contrast"
                        },
                        {
                            "text": "MRI breast",
                            "template": "MRI breast"
                        }
                    ]
                },
                {
                    "text": "Plain films",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "X-ray chest, PA and lateral",
                            "template": "X-ray chest, PA and lateral"
                        },
                        {
                            "text": "X-ray abdomen (KUB)",
                            "template": "X-ray abdomen (KUB)"
                        }
                    ]
                },
                {
                    "text": "Ultrasound",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "US bladder",
                            "template": "US bladder"
                        },
                        {
                            "text": "US pelvis",
                            "template": "US pelvis"
                        },
                        {
                            "text": "US renal",
                            "template": "US renal"
                        },
                        {
                            "text": "US urethra",
                            "template": "US urethra"
                        }
                    ]
                },
                {
                    "text": "Osteoporosis screening",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Bone densitometry (DXA)",
                            "template": "Bone densitometry (DXA)"
                        }
                    ]
                },
                {
                    "text": "Other",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Intravenous pyelogram (IVP)",
                            "template": "Intravenous pyelogram (IVP)"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Ordered Procedures",
            "template": "Ordered Procedures{children}",
            "children": [
                {
                    "text": "Procedures",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Colonoscopy",
                            "template": "Colonoscopy"
                        },
                        {
                            "text": "Flexible sigmoidoscopy",
                            "template": "Flexible sigmoidoscopy"
                        },
                        {
                            "text": "EKG, 12-lead",
                            "template": "EKG, 12-lead"
                        },
                        {
                            "text": "Exercise treadmill test",
                            "template": "Exercise treadmill test"
                        },
                        {
                            "text": "EGD",
                            "template": "EGD"
                        },
                        {
                            "text": "PPD (purified protein derivative) skin test",
                            "template": "PPD (purified protein derivative) skin test"
                        },
                        {
                            "text": "Coloposcopy",
                            "template": "Coloposcopy"
                        },
                        {
                            "text": "Endometrial biopsy",
                            "template": "Endometrial biopsy"
                        },
                        {
                            "text": "Vulvar biopsy",
                            "template": "Vulvar biopsy"
                        },
                        {
                            "text": "Hysteroscopy",
                            "template": "Hysteroscopy"
                        },
                        {
                            "text": "Hysteroscopy with Essure",
                            "template": "Hysteroscopy with Essure"
                        },
                        {
                            "text": "Insertion IUD",
                            "template": "Insertion IUD"
                        },
                        {
                            "text": "Laser Treatment of Condyloma",
                            "template": "Laser Treatment of Condyloma"
                        },
                        {
                            "text": "Laser Treatment of BCA",
                            "template": "Laser Treatment of BCA"
                        },
                        {
                            "text": "Cryocautery of cervix",
                            "template": "Cryocautery of cervix"
                        },
                        {
                            "text": "LEEP",
                            "template": "LEEP"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Ordered Medications",
            "template": "Ordered Medications{children}",
            "children": [
                {
                    "text": "Oral contraceptives",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Monophasic OCPs",
                            "template": "Monophasic OCPs"
                        },
                        {
                            "text": "Biphasic OCPs",
                            "template": "Biphasic OCPs"
                        },
                        {
                            "text": "Triphasic OCPs",
                            "template": "Triphasic OCPs"
                        },
                        {
                            "text": "Progestin-only OCPs",
                            "template": "Progestin-only OCPs"
                        },
                        {
                            "text": "Brevicon 35 mcg\/0.5 mg [28 day] pack",
                            "template": "Brevicon 35 mcg\/0.5 mg [28 day] pack"
                        },
                        {
                            "text": "Lo Loestrin Fe monophasic [28 day] pack",
                            "template": "Lo Loestrin Fe monophasic [28 day] pack"
                        },
                        {
                            "text": "Loestrin 24 Fe 20 mcg\/1 mg [28 day] pack",
                            "template": "Loestrin 24 Fe 20 mcg\/1 mg [28 day] pack"
                        },
                        {
                            "text": "Lo\/Ovral-28 monophasic [28 day] pack",
                            "template": "Lo\/Ovral-28 monophasic [28 day] pack"
                        },
                        {
                            "text": "Modicon 35 mcg\/0.5 mg [28 day] pack",
                            "template": "Modicon 35 mcg\/0.5 mg [28 day] pack"
                        },
                        {
                            "text": "Ocella 3 mg\/30 mcg [28 day] pack",
                            "template": "Ocella 3 mg\/30 mcg [28 day] pack"
                        },
                        {
                            "text": "Ortho-Cyclen 35 mcg\/0.25 mg [28 day] pack",
                            "template": "Ortho-Cyclen 35 mcg\/0.25 mg [28 day] pack"
                        },
                        {
                            "text": "Ortho-Novum 1\/35 35 mcg\/1 mg [28 day] pack",
                            "template": "Ortho-Novum 1\/35 35 mcg\/1 mg [28 day] pack"
                        },
                        {
                            "text": "Yasmin monophasic [28 day] pack",
                            "template": "Yasmin monophasic [28 day] pack"
                        },
                        {
                            "text": "Yaz 3 mg\/20 mcg [28 day] pack",
                            "template": "Yaz 3 mg\/20 mcg [28 day] pack"
                        },
                        {
                            "text": "Necon 10\/11 biphasic [28 day] pack",
                            "template": "Necon 10\/11 biphasic [28 day] pack"
                        },
                        {
                            "text": "Ortho Tri-Cyclen Lo triphasic [28 day] pack",
                            "template": "Ortho Tri-Cyclen Lo triphasic [28 day] pack"
                        },
                        {
                            "text": "Ortho Tri-Cyclen triphasic [28 day] pack",
                            "template": "Ortho Tri-Cyclen triphasic [28 day] pack"
                        },
                        {
                            "text": "TriNessa triphasic [28 day] pack",
                            "template": "TriNessa triphasic [28 day] pack"
                        },
                        {
                            "text": "Ortho Micronor 0.35 mg [28 day] pack",
                            "template": "Ortho Micronor 0.35 mg [28 day] pack"
                        }
                    ]
                },
                {
                    "text": "Oral contraceptives extended cycle",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Jolessa monophasic [91 day] pack",
                            "template": "Jolessa monophasic [91 day] pack"
                        },
                        {
                            "text": "Lybrel monophasic [28 day] pack",
                            "template": "Lybrel monophasic [28 day] pack"
                        },
                        {
                            "text": "Seasonique biphasic [91 day] pack",
                            "template": "Seasonique biphasic [91 day] pack"
                        },
                        {
                            "text": "Seasonale 30 mcg\/0.15 mg [91 day] pack",
                            "template": "Seasonale 30 mcg\/0.15 mg [91 day] pack"
                        }
                    ]
                },
                {
                    "text": "Contraceptive patch, ring, IUD, injection",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "medroxyprogesterone acetate INJ",
                            "template": "medroxyprogesterone acetate INJ"
                        },
                        {
                            "text": "Depo-Provera INJ",
                            "template": "Depo-Provera INJ"
                        },
                        {
                            "text": "NuvaRing 0.12 mg\/0.015 mg per day ring",
                            "template": "NuvaRing 0.12 mg\/0.015 mg per day ring"
                        },
                        {
                            "text": "Mirena 52 mg IUD",
                            "template": "Mirena 52 mg IUD"
                        },
                        {
                            "text": "Ortho Evra 150 mcg\/20 mcg per 24h patch",
                            "template": "Ortho Evra 150 mcg\/20 mcg per 24h patch"
                        }
                    ]
                },
                {
                    "text": "Atrophic vaginitis tx",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Use OTC water-based vaginal moisturizer per pkg instructions",
                            "template": "Use OTC water-based vaginal moisturizer per pkg instructions"
                        },
                        {
                            "text": "Use OTC vaginal lubricant before sexual activity, per pkg instructions",
                            "template": "Use OTC vaginal lubricant before sexual activity, per pkg instructions"
                        },
                        {
                            "text": "Estring 2 mg ring",
                            "template": "Estring 2 mg ring"
                        },
                        {
                            "text": "Vagifem 10 mcg tab",
                            "template": "Vagifem 10 mcg tab"
                        },
                        {
                            "text": "Premarin Vaginal 0.625 mg per g cream",
                            "template": "Premarin Vaginal 0.625 mg per g cream"
                        },
                        {
                            "text": "Premarin Vaginal 0.625 mg per g cream",
                            "template": "Premarin Vaginal 0.625 mg per g cream"
                        },
                        {
                            "text": "Estrace Vaginal 0.01% cream",
                            "template": "Estrace Vaginal 0.01% cream"
                        },
                        {
                            "text": "Ospemifene 60 mg",
                            "template": "Ospemifene 60 mg"
                        }
                    ]
                },
                {
                    "text": "Vaginal antimicrobials",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Take OTC antifungal vaginal topic product as directed",
                            "template": "Take OTC antifungal vaginal topic product as directed"
                        },
                        {
                            "text": "metronidazole vaginal 0.75% gel",
                            "template": "metronidazole vaginal 0.75% gel"
                        },
                        {
                            "text": "terconazole vaginal 0.80% cream",
                            "template": "terconazole vaginal 0.80% cream"
                        }
                    ]
                },
                {
                    "text": "Hormone therapy",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Estrogens (if intact uterus, add progestin)",
                            "template": "Estrogens (if intact uterus, add progestin)"
                        },
                        {
                            "text": "Progestins",
                            "template": "Progestins"
                        },
                        {
                            "text": "Combinations",
                            "template": "Combinations"
                        },
                        {
                            "text": "estradiol 0.5 mg tab",
                            "template": "estradiol 0.5 mg tab"
                        },
                        {
                            "text": "estradiol 1 mg tab",
                            "template": "estradiol 1 mg tab"
                        },
                        {
                            "text": "Activella 0.5 mg\/0.1 mg [28 day] pack",
                            "template": "Activella 0.5 mg\/0.1 mg [28 day] pack"
                        },
                        {
                            "text": "Cenestin 0.625 mg tab",
                            "template": "Cenestin 0.625 mg tab"
                        },
                        {
                            "text": "Climara 0.025 mg per day patch",
                            "template": "Climara 0.025 mg per day patch"
                        },
                        {
                            "text": "Divigel 0.25 mg gel",
                            "template": "Divigel 0.25 mg gel"
                        },
                        {
                            "text": "Enjuvia 0.3 mg tab",
                            "template": "Enjuvia 0.3 mg tab"
                        },
                        {
                            "text": "Estraderm 0.05 mg per day patch",
                            "template": "Estraderm 0.05 mg per day patch"
                        },
                        {
                            "text": "Premarin 0.3 mg tab",
                            "template": "Premarin 0.3 mg tab"
                        },
                        {
                            "text": "Premarin 0.625 mg tab",
                            "template": "Premarin 0.625 mg tab"
                        },
                        {
                            "text": "Vivelle-Dot 0.0375 mg per day patch",
                            "template": "Vivelle-Dot 0.0375 mg per day patch"
                        },
                        {
                            "text": "medroxyprogesterone 2.5 mg tab",
                            "template": "medroxyprogesterone 2.5 mg tab"
                        },
                        {
                            "text": "medroxyprogesterone 5 mg tab",
                            "template": "medroxyprogesterone 5 mg tab"
                        },
                        {
                            "text": "medroxyprogesterone 10 mg tab",
                            "template": "medroxyprogesterone 10 mg tab"
                        },
                        {
                            "text": "estradiol\/norethindrone acetate 0.5 mg\/0.1 mg [28 day] pack",
                            "template": "estradiol\/norethindrone acetate 0.5 mg\/0.1 mg [28 day] pack"
                        },
                        {
                            "text": "Angeliq 0.5 mg\/1 mg [28 day] pack",
                            "template": "Angeliq 0.5 mg\/1 mg [28 day] pack"
                        },
                        {
                            "text": "Combipatch 0.05 mg\/0.14 mg per day patch",
                            "template": "Combipatch 0.05 mg\/0.14 mg per day patch"
                        },
                        {
                            "text": "Climara Pro 0.045 mg\/0.015 mg per day patch",
                            "template": "Climara Pro 0.045 mg\/0.015 mg per day patch"
                        },
                        {
                            "text": "Premphase biphasic [28 day] pack",
                            "template": "Premphase biphasic [28 day] pack"
                        },
                        {
                            "text": "Prempro 0.3 mg\/1.5 mg [28 day] pack",
                            "template": "Prempro 0.3 mg\/1.5 mg [28 day] pack"
                        },
                        {
                            "text": "Ospemifene 60 mg",
                            "template": "Ospemifene 60 mg"
                        }
                    ]
                },
                {
                    "text": "Vitamins, Supplements",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "calcium carbonate 500 mg chew tab",
                            "template": "calcium carbonate 500 mg chew tab"
                        },
                        {
                            "text": "calcium carbonate 600 mg tab",
                            "template": "calcium carbonate 600 mg tab"
                        },
                        {
                            "text": "folic acid 0.4 mg tab",
                            "template": "folic acid 0.4 mg tab"
                        },
                        {
                            "text": "vitamin D3 (common name) 400 units cap",
                            "template": "vitamin D3 (common name) 400 units cap"
                        },
                        {
                            "text": "vitamin D3 (common name) 1000 units tab",
                            "template": "vitamin D3 (common name) 1000 units tab"
                        }
                    ]
                },
                {
                    "text": "Smoking cessation",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "nicotine transdermal 7 mg per 24h patch",
                            "template": "nicotine transdermal 7 mg per 24h patch"
                        },
                        {
                            "text": "nicotine transdermal 14 mg per 24h patch",
                            "template": "nicotine transdermal 14 mg per 24h patch"
                        },
                        {
                            "text": "nicotine transdermal 21 mg per 24h patch",
                            "template": "nicotine transdermal 21 mg per 24h patch"
                        },
                        {
                            "text": "Chantix 0.5 mg tab",
                            "template": "Chantix 0.5 mg tab"
                        },
                        {
                            "text": "Zyban 150 mg ER tab",
                            "template": "Zyban 150 mg ER tab"
                        }
                    ]
                },
                {
                    "text": "Laxatives, Stool softeners",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "bisacodyl 5 mg EC tab",
                            "template": "bisacodyl 5 mg EC tab"
                        },
                        {
                            "text": "bisacodyl rectal 10 mg supp",
                            "template": "bisacodyl rectal 10 mg supp"
                        },
                        {
                            "text": "docusate sodium 100 mg cap",
                            "template": "docusate sodium 100 mg cap"
                        },
                        {
                            "text": "polyethylene glycol 3350 17 g solution",
                            "template": "polyethylene glycol 3350 17 g solution"
                        },
                        {
                            "text": "sennosides 8.6 mg tab",
                            "template": "sennosides 8.6 mg tab"
                        }
                    ]
                },
                {
                    "text": "Analgesics",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "ibuprofen 400 mg tab",
                            "template": "ibuprofen 400 mg tab"
                        },
                        {
                            "text": "ibuprofen 600 mg tab",
                            "template": "ibuprofen 600 mg tab"
                        },
                        {
                            "text": "ibuprofen 800 mg tab",
                            "template": "ibuprofen 800 mg tab"
                        },
                        {
                            "text": "naproxen 250 mg tab",
                            "template": "naproxen 250 mg tab"
                        }
                    ]
                },
                {
                    "text": "Aspirin",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "aspirin 81 mg tab",
                            "template": "aspirin 81 mg tab"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Ordered Immunizations",
            "template": "Ordered Immunizations{children}",
            "children": [
                {
                    "text": "Immunizations",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Vaccination, influenza",
                            "template": "Vaccination, influenza"
                        },
                        {
                            "text": "Vaccination, hepatitis A",
                            "template": "Vaccination, hepatitis A"
                        },
                        {
                            "text": "Vaccination, hepatitis B",
                            "template": "Vaccination, hepatitis B"
                        },
                        {
                            "text": "Vaccination, HPV",
                            "template": "Vaccination, HPV"
                        },
                        {
                            "text": "Vaccination, MMR",
                            "template": "Vaccination, MMR"
                        },
                        {
                            "text": "Vaccination, meningococcus",
                            "template": "Vaccination, meningococcus"
                        },
                        {
                            "text": "Vaccination, pneumococcus",
                            "template": "Vaccination, pneumococcus"
                        },
                        {
                            "text": "Vaccination, tetanus",
                            "template": "Vaccination, tetanus"
                        },
                        {
                            "text": "Vaccination, varicella",
                            "template": "Vaccination, varicella"
                        },
                        {
                            "text": "Vaccination, zoster",
                            "template": "Vaccination, zoster"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Patient Instructions",
            "template": "Patient Instructions{children}",
            "children": [
                {
                    "text": "Patient instructions",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Follow healthy diet",
                            "template": "Follow healthy diet"
                        },
                        {
                            "text": "Regular exercise (3x\/week or more)",
                            "template": "Regular exercise (3x\/week or more)"
                        },
                        {
                            "text": "Pre conception counseling",
                            "template": "Pre conception counseling"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Follow-up, Referrals",
            "template": "Follow Up, Referrals{children}",
            "children": [
                {
                    "text": "Return visits",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Return visit as needed",
                            "template": "Return visit as needed"
                        },
                        {
                            "text": "Return visit in 1 year",
                            "template": "Return visit in 1 year"
                        }
                    ]
                },
                {
                    "text": "Referrals",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Refer to Allergy",
                            "template": "Refer to Allergy"
                        },
                        {
                            "text": "Refer to Audiology",
                            "template": "Refer to Audiology"
                        },
                        {
                            "text": "Refer to Cardiology",
                            "template": "Refer to Cardiology"
                        },
                        {
                            "text": "Refer to Dermatology",
                            "template": "Refer to Dermatology"
                        },
                        {
                            "text": "Refer to dietician",
                            "template": "Refer to dietician"
                        },
                        {
                            "text": "Refer to Nutrition",
                            "template": "Refer to Nutrition"
                        },
                        {
                            "text": "Refer to ENT",
                            "template": "Refer to ENT"
                        },
                        {
                            "text": "Refer to Hematology\/Oncology",
                            "template": "Refer to Hematology\/Oncology"
                        },
                        {
                            "text": "Refer to Endocrinology",
                            "template": "Refer to Endocrinology"
                        },
                        {
                            "text": "Refer to General Surgery",
                            "template": "Refer to General Surgery"
                        },
                        {
                            "text": "Refer to GI",
                            "template": "Refer to GI"
                        },
                        {
                            "text": "Refer to Gynecological Oncology",
                            "template": "Refer to Gynecological Oncology"
                        },
                        {
                            "text": "Refer to Nephrology",
                            "template": "Refer to Nephrology"
                        },
                        {
                            "text": "Refer to Neurology",
                            "template": "Refer to Neurology"
                        },
                        {
                            "text": "Refer to OB\/Gyn",
                            "template": "Refer to OB\/Gyn"
                        },
                        {
                            "text": "Refer to Occupational Therapy",
                            "template": "Refer to Occupational Therapy"
                        },
                        {
                            "text": "Refer to Ophthalmology",
                            "template": "Refer to Ophthalmology"
                        },
                        {
                            "text": "Refer to Orthopedic Surgery",
                            "template": "Refer to Orthopedic Surgery"
                        },
                        {
                            "text": "Refer to Pain Management",
                            "template": "Refer to Pain Management"
                        },
                        {
                            "text": "Refer to Physical Therapy",
                            "template": "Refer to Physical Therapy"
                        },
                        {
                            "text": "Refer to Psychiatry",
                            "template": "Refer to Psychiatry"
                        },
                        {
                            "text": "Refer to Pulmonary",
                            "template": "Refer to Pulmonary"
                        },
                        {
                            "text": "Refer to Reproductive Endocrinology",
                            "template": "Refer to Reproductive Endocrinology"
                        },
                        {
                            "text": "Refer to Rheumatology",
                            "template": "Refer to Rheumatology"
                        },
                        {
                            "text": "Refer to smoking cessation program",
                            "template": "Refer to smoking cessation program"
                        }
                    ]
                }
            ]
        }
    ]
}