{
    "section": "subjective",
    "templateSet": "Venous insufficiency",
    "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 venous insufficiency symptoms",
                    "template": "initial evaluation of venous insufficiency symptoms"
                },
                {
                    "text": "follow-up venous insufficiency evaluation",
                    "template": "follow-up evaluation of venous insufficiency"
                },
                {
                    "text": "ongoing venous insufficiency management",
                    "template": "ongoing management of venous insufficiency"
                },
                {
                    "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": "intermittent presence of symptoms",
                    "template": "symptoms are described as intermittently present"
                },
                {
                    "text": "Duration (months)",
                    "template": "is reported as having been present for {text} months",
                    "type": "number"
                },
                {
                    "text": "Duration (years)",
                    "template": "is reported as having been present for {text} years",
                    "type": "number"
                },
                {
                    "text": "Duration (describe)",
                    "template": "is reported as having been present for {text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Symptoms",
            "template": "Patient reports the presence\/absence of the following Hx\/sx related to the current\n                        visit: {children}.\n                    ",
            "children": [
                {
                    "text": "no complaints",
                    "template": "reports no complaints"
                },
                {
                    "text": "pain at rest",
                    "template": "pain at rest",
                    "type": "plus-minus"
                },
                {
                    "text": "pain wth ambulation",
                    "template": "pain wth ambulation",
                    "type": "plus-minus"
                },
                {
                    "text": "pain limiting ambulation",
                    "template": "pain limiting ambulation",
                    "type": "plus-minus"
                },
                {
                    "text": "lower extremity ulcers",
                    "template": "lower extremity ulcers",
                    "type": "plus-minus"
                },
                {
                    "text": "leg swelling",
                    "template": "leg swelling",
                    "type": "plus-minus"
                },
                {
                    "text": "leg cramps at night",
                    "template": "leg cramps at night",
                    "type": "plus-minus"
                },
                {
                    "text": "leg heaviness with exercise",
                    "template": "leg heaviness with exercise",
                    "type": "plus-minus"
                },
                {
                    "text": "leg fatigue",
                    "template": "leg fatigue",
                    "type": "plus-minus"
                },
                {
                    "text": "itching",
                    "template": "itching",
                    "type": "plus-minus"
                },
                {
                    "text": "Other sx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Pain detail",
            "template": "Pain is present and described as {children}.",
            "children": [
                {
                    "text": "Localization",
                    "template": "affecting the {children}",
                    "children": [
                        {
                            "text": "RLE",
                            "template": "RLE"
                        },
                        {
                            "text": "LLE",
                            "template": "LLE"
                        },
                        {
                            "text": "BL LE",
                            "template": "BL LE"
                        },
                        {
                            "text": "entire R leg",
                            "template": "entire R leg"
                        },
                        {
                            "text": "entire L leg",
                            "template": "entire L leg"
                        },
                        {
                            "text": "R thigh",
                            "template": "R thigh"
                        },
                        {
                            "text": "L thigh",
                            "template": "L thigh"
                        },
                        {
                            "text": "R calf",
                            "template": "R calf"
                        },
                        {
                            "text": "L calf",
                            "template": "L calf"
                        }
                    ]
                },
                {
                    "text": "Quality",
                    "template": "having {children} quality",
                    "children": [
                        {
                            "text": "heaviness",
                            "template": "a sensation of heaviness"
                        },
                        {
                            "text": "sharp",
                            "template": "a sharp"
                        },
                        {
                            "text": "dull",
                            "template": "a dull"
                        },
                        {
                            "text": "aching",
                            "template": "an aching"
                        },
                        {
                            "text": "spasm",
                            "template": "spasm-like"
                        },
                        {
                            "text": "electric",
                            "template": "an electric"
                        }
                    ]
                },
                {
                    "text": "Radiation",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "nonradiating",
                            "template": "nonradiating"
                        },
                        {
                            "text": "radiating",
                            "template": "radiating"
                        }
                    ]
                },
                {
                    "text": "Severity (0-10, 10=worst)",
                    "template": "having a severity rated as {children}",
                    "children": [
                        {
                            "text": "mild",
                            "template": "mild"
                        },
                        {
                            "text": "moderate",
                            "template": "moderate"
                        },
                        {
                            "text": "severe",
                            "template": "severe"
                        },
                        {
                            "text": "0\/10 (no pain)",
                            "template": "0\/10 (no pain)"
                        },
                        {
                            "text": "+1\/10",
                            "template": "+1\/10 (10=worst)"
                        },
                        {
                            "text": "+2\/10",
                            "template": "+2\/10 (10=worst)"
                        },
                        {
                            "text": "+3\/10",
                            "template": "+3\/10 (10=worst)"
                        },
                        {
                            "text": "+4\/10",
                            "template": "+4\/10 (10=worst)"
                        },
                        {
                            "text": "+5\/10",
                            "template": "+5\/10 (10=worst)"
                        },
                        {
                            "text": "+6\/10",
                            "template": "+6\/10 (10=worst)"
                        },
                        {
                            "text": "+7\/10",
                            "template": "+7\/10 (10=worst)"
                        },
                        {
                            "text": "+8\/10",
                            "template": "+8\/10 (10=worst)"
                        },
                        {
                            "text": "+9\/10",
                            "template": "+9\/10 (10=worst)"
                        },
                        {
                            "text": "+10\/10",
                            "template": "+10\/10 (10=worst)"
                        }
                    ]
                },
                {
                    "text": "Timing: constant, intermittent",
                    "template": "being {children}",
                    "children": [
                        {
                            "text": "constantly present",
                            "template": "constantly present"
                        },
                        {
                            "text": "intermittently present",
                            "template": "intermittently present"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Pertinent positives\/negatives",
            "template": "Pertinent positive\/negative symptoms include {children}.",
            "children": [
                {
                    "text": "fever",
                    "template": "fever",
                    "type": "plus-minus"
                },
                {
                    "text": "weight gain",
                    "template": "weight gain",
                    "type": "plus-minus"
                },
                {
                    "text": "snoring",
                    "template": "snoring",
                    "type": "plus-minus"
                },
                {
                    "text": "dyspnea",
                    "template": "dyspnea",
                    "type": "plus-minus"
                },
                {
                    "text": "orthopnea",
                    "template": "orthopnea",
                    "type": "plus-minus"
                },
                {
                    "text": "paroxysmal nocturnal dyspnea",
                    "template": "paroxysmal nocturnal dyspnea",
                    "type": "plus-minus"
                },
                {
                    "text": "decreased exercise tolerance",
                    "template": "decreased exercise tolerance",
                    "type": "plus-minus"
                },
                {
                    "text": "cough",
                    "template": "cough",
                    "type": "plus-minus"
                },
                {
                    "text": "pleuritic chest pain",
                    "template": "pleuritic chest pain",
                    "type": "plus-minus"
                },
                {
                    "text": "chest pain",
                    "template": "chest pain",
                    "type": "plus-minus"
                },
                {
                    "text": "palpitations",
                    "template": "palpitations",
                    "type": "plus-minus"
                },
                {
                    "text": "syncope",
                    "template": "syncope",
                    "type": "plus-minus"
                },
                {
                    "text": "presyncope",
                    "template": "presyncope",
                    "type": "plus-minus"
                },
                {
                    "text": "paresthesias",
                    "template": "paresthesias",
                    "type": "plus-minus"
                },
                {
                    "text": "Other pertinent sx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Exacerbating\/Alleviating factors",
            "template": "Patient reports that {children}.",
            "children": [
                {
                    "text": "Prolonged walking",
                    "template": "prolonged walking {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "improves sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been observed",
                            "template": "has not been observed"
                        }
                    ]
                },
                {
                    "text": "Prolonged standing",
                    "template": "prolonged standing {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "improves sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been observed",
                            "template": "has not been observed"
                        }
                    ]
                },
                {
                    "text": "Trauma",
                    "template": "trauma {children}",
                    "children": [
                        {
                            "text": "worsens sx",
                            "template": "has worsened sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has had no effect on sx"
                        },
                        {
                            "text": "has not been observed",
                            "template": "has not been observed"
                        }
                    ]
                },
                {
                    "text": "Rest",
                    "template": "rest {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "improves sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been observed",
                            "template": "has not been observed"
                        }
                    ]
                },
                {
                    "text": "Elevation of affected area",
                    "template": "elevation of affected area {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "improves sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been tried",
                            "template": "has not been tried"
                        }
                    ]
                },
                {
                    "text": "Compression stockings",
                    "template": "compression stockings {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": "Diuretics",
                    "template": "diuretics {children}",
                    "children": [
                        {
                            "text": "improve sx",
                            "template": "improve sx"
                        },
                        {
                            "text": "worsen sx",
                            "template": "worsen sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "have no effect on sx"
                        },
                        {
                            "text": "have not been tried",
                            "template": "have not been tried"
                        }
                    ]
                },
                {
                    "text": "Other contributing factors (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Medical Hx specific to visit",
            "template": "Medical history includes {children}.",
            "children": [
                {
                    "text": "cardiovascular disease",
                    "template": "cardiovascular disease",
                    "type": "plus-minus"
                },
                {
                    "text": "myocardial infarction",
                    "template": "myocardial infarction",
                    "type": "plus-minus"
                },
                {
                    "text": "CHF",
                    "template": "CHF",
                    "type": "plus-minus"
                },
                {
                    "text": "peripheral vascular disease",
                    "template": "peripheral vascular disease",
                    "type": "plus-minus"
                },
                {
                    "text": "stroke",
                    "template": "stroke",
                    "type": "plus-minus"
                },
                {
                    "text": "hypertension",
                    "template": "hypertension",
                    "type": "plus-minus"
                },
                {
                    "text": "DVT",
                    "template": "DVT",
                    "type": "plus-minus"
                },
                {
                    "text": "thrombophlebitis",
                    "template": "thrombophlebitis",
                    "type": "plus-minus"
                },
                {
                    "text": "PE",
                    "template": "PE",
                    "type": "plus-minus"
                },
                {
                    "text": "COPD",
                    "template": "COPD",
                    "type": "plus-minus"
                },
                {
                    "text": "asthma",
                    "template": "asthma",
                    "type": "plus-minus"
                },
                {
                    "text": "kidney disease",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "CKD stage 1",
                            "template": "CKD stage 1",
                            "type": "plus-minus"
                        },
                        {
                            "text": "CKD stage 2 (mild)",
                            "template": "CKD stage 2 (mild)",
                            "type": "plus-minus"
                        },
                        {
                            "text": "CKD stage 3 (moderate)",
                            "template": "CKD stage 3 (moderate)",
                            "type": "plus-minus"
                        },
                        {
                            "text": "CKD stage 4 (severe)",
                            "template": "CKD stage 4 (severe)",
                            "type": "plus-minus"
                        },
                        {
                            "text": "ESRD",
                            "template": "End Stage Renal Disease",
                            "type": "plus-minus"
                        }
                    ]
                },
                {
                    "text": "hepatitis",
                    "template": "hepatitis",
                    "type": "plus-minus"
                },
                {
                    "text": "cirrhosis",
                    "template": "cirrhosis",
                    "type": "plus-minus"
                },
                {
                    "text": "overweight\/obesity",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "overweight",
                            "template": "overweight",
                            "type": "plus-minus"
                        },
                        {
                            "text": "obese",
                            "template": "obese",
                            "type": "plus-minus"
                        },
                        {
                            "text": "morbid obesity",
                            "template": "morbid obesity",
                            "type": "plus-minus"
                        }
                    ]
                },
                {
                    "text": "obesity contributing factors (describe)",
                    "template": "obesity contributing factors {text}",
                    "type": "alpha"
                },
                {
                    "text": "Other medical Hx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "OB\/Gyn Hx specific to visit",
            "template": "OB\/Gyn history includes {children}.",
            "children": [
                {
                    "text": "LMP (specify)",
                    "template": "LMP: {text}",
                    "type": "date"
                },
                {
                    "text": "pregnant",
                    "template": "pregnant",
                    "type": "plus-minus"
                },
                {
                    "text": "Other OB\/Gyn Hx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Lifestyle\/Environment factors",
            "template": "Lifestyle\/Environment factors include {children}.",
            "children": [
                {
                    "text": "alcohol use",
                    "template": "alcohol use",
                    "type": "plus-minus"
                },
                {
                    "text": "alcohol abuse",
                    "template": "alcohol abuse",
                    "type": "plus-minus"
                },
                {
                    "text": "Other lifestyle\/exposure (specify)",
                    "template": "(+) {text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Smoking status",
            "template": "Smoking status: {children}.",
            "children": [
                {
                    "text": "nonsmoker",
                    "template": "nonsmoker"
                },
                {
                    "text": "tobacco abuse",
                    "template": "tobacco abuse",
                    "type": "plus-minus"
                },
                {
                    "text": "tobacco dependence",
                    "template": "tobacco dependence",
                    "type": "plus-minus"
                },
                {
                    "text": "tobacco products used",
                    "template": "tobacco products used include {children}",
                    "children": [
                        {
                            "text": "cigarettes",
                            "template": "cigarettes"
                        },
                        {
                            "text": "cigars",
                            "template": "cigars"
                        },
                        {
                            "text": "pipes",
                            "template": "pipes"
                        },
                        {
                            "text": "water pipes",
                            "template": "water pipes"
                        },
                        {
                            "text": "chew",
                            "template": "chew"
                        },
                        {
                            "text": "snuff",
                            "template": "snuff"
                        }
                    ]
                },
                {
                    "text": "packs per day (specify)",
                    "template": "{text} packs per day",
                    "type": "number"
                },
                {
                    "text": "age at smoking onset (specify)",
                    "template": "started smoking at age {text}",
                    "type": "number"
                },
                {
                    "text": "smoking duration (months)",
                    "template": "smoking duration is {text} months",
                    "type": "number"
                },
                {
                    "text": "smoking duration (years)",
                    "template": "smoking duration is {text} years",
                    "type": "number"
                },
                {
                    "text": "tobacco withdrawal",
                    "template": "tobacco withdrawal",
                    "type": "plus-minus"
                },
                {
                    "text": "tobacco remission",
                    "template": "tobacco remission",
                    "type": "plus-minus"
                },
                {
                    "text": "hx of nicotine dependence (describe)",
                    "template": "{text}",
                    "type": "alpha"
                },
                {
                    "text": "second hand smoke type\/exposure (describe)",
                    "template": "{text}",
                    "type": "alpha"
                },
                {
                    "text": "other (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Family Hx specific to visit",
            "template": "Family history includes {children}.",
            "children": [
                {
                    "text": "cardiovascular disease",
                    "template": "cardiovascular disease",
                    "type": "plus-minus"
                },
                {
                    "text": "premature CAD, male relative",
                    "template": "MI and\/or sudden death in father\/male relative at < 55 yo",
                    "type": "plus-minus"
                },
                {
                    "text": "premature CAD, female relative",
                    "template": "MI and\/or sudden death in mother\/female relative at < 65 yo",
                    "type": "plus-minus"
                },
                {
                    "text": "stroke",
                    "template": "stroke",
                    "type": "plus-minus"
                },
                {
                    "text": "hypercholesterolemia",
                    "template": "hypercholesterolemia",
                    "type": "plus-minus"
                },
                {
                    "text": "diabetes",
                    "template": "diabetes",
                    "type": "plus-minus"
                },
                {
                    "text": "hypertension",
                    "template": "hypertension",
                    "type": "plus-minus"
                },
                {
                    "text": "hypercoagulable disorder",
                    "template": "hypercoagulable disorder",
                    "type": "plus-minus"
                },
                {
                    "text": "Other family Hx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        }
    ]
}