{
    "section": "plan",
    "templateSet": "Smoking cessation",
    "templates": [
        {
            "text": "Medications",
            "template": "{children}",
            "children": [
                {
                    "text": "Nicotine replacement",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "6-10 cigarettes per day",
                            "template": "6-10 cigarettes per day"
                        },
                        {
                            "text": ">10 cigarettes per day",
                            "template": ">10 cigarettes per day"
                        },
                        {
                            "text": "nicotine lozenge 2 mg lozenge",
                            "template": "nicotine lozenge 2 mg lozenge"
                        },
                        {
                            "text": "nicotine gum 2 mg gum",
                            "template": "nicotine gum 2 mg gum"
                        },
                        {
                            "text": "nicotine gum 4 mg gum",
                            "template": "nicotine gum 4 mg gum"
                        },
                        {
                            "text": "Nicotrol Inhaler 4 mg cartridge",
                            "template": "Nicotrol Inhaler 4 mg cartridge"
                        },
                        {
                            "text": "Nicotrol NS 0.5 mg per spray solution",
                            "template": "Nicotrol NS 0.5 mg per spray solution"
                        },
                        {
                            "text": "nicotine transdermal 14 mg per 24h patch",
                            "template": "nicotine transdermal 14 mg per 24h patch"
                        },
                        {
                            "text": "nicotine transdermal 7 mg per 24h patch",
                            "template": "nicotine transdermal 7 mg per 24h patch"
                        },
                        {
                            "text": "nicotine transdermal 21 mg per 24h patch",
                            "template": "nicotine transdermal 21 mg per 24h patch"
                        },
                        {
                            "text": "nicotine transdermal 14 mg per 24h patch",
                            "template": "nicotine transdermal 14 mg per 24h patch"
                        },
                        {
                            "text": "nicotine transdermal 7 mg per 24h patch",
                            "template": "nicotine transdermal 7 mg per 24h patch"
                        }
                    ]
                },
                {
                    "text": "Oral medications",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "bupropion HCl 150 mg per 12h ER tab",
                            "template": "bupropion HCl 150 mg per 12h ER tab"
                        },
                        {
                            "text": "Chantix 0.5 mg tab",
                            "template": "Chantix 0.5 mg tab"
                        },
                        {
                            "text": "Chantix 1 mg tab",
                            "template": "Chantix 1 mg tab"
                        },
                        {
                            "text": "Chantix 0.5 mg\/1 mg [starting month] pack",
                            "template": "Chantix 0.5 mg\/1 mg [starting month] pack"
                        },
                        {
                            "text": "Chantix 1 mg [continuing month] pack",
                            "template": "Chantix 1 mg [continuing month] pack"
                        },
                        {
                            "text": "clonidine 0.1 mg tab",
                            "template": "clonidine 0.1 mg tab"
                        },
                        {
                            "text": "clonidine transdermal 0.1 mg per 24h patch",
                            "template": "clonidine transdermal 0.1 mg per 24h patch"
                        },
                        {
                            "text": "clonidine transdermal 0.2 mg per 24h patch",
                            "template": "clonidine transdermal 0.2 mg per 24h patch"
                        },
                        {
                            "text": "clonidine transdermal 0.3 mg per 24h patch",
                            "template": "clonidine transdermal 0.3 mg per 24h patch"
                        },
                        {
                            "text": "nortriptyline 25 mg cap",
                            "template": "nortriptyline 25 mg cap"
                        },
                        {
                            "text": "nortriptyline 50 mg cap",
                            "template": "nortriptyline 50 mg cap"
                        },
                        {
                            "text": "nortriptyline 75 mg cap",
                            "template": "nortriptyline 75 mg cap"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Patient instructions",
            "template": "{children}",
            "children": [
                {
                    "text": "Smoking cessation counseling, ready to quit",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Tobacco counseling 3-10 minutes performed",
                            "template": "Tobacco counseling 3-10 minutes performed"
                        },
                        {
                            "text": "Tobacco counseling >10 minutes performed",
                            "template": "Tobacco counseling >10 minutes performed"
                        },
                        {
                            "text": "Discontinue smoking while on nicotine replacement",
                            "template": "Discontinue smoking while on nicotine replacement"
                        },
                        {
                            "text": "Remove cigarettes and ashtrays from environment",
                            "template": "Remove cigarettes and ashtrays from environment"
                        },
                        {
                            "text": "Inform family\/friends of intention to quit",
                            "template": "Inform family\/friends of intention to quit"
                        }
                    ]
                },
                {
                    "text": "Smoking cessation counseling, not ready to quit",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Tobacco counseling 3-10 minutes performed",
                            "template": "Tobacco counseling 3-10 minutes performed"
                        },
                        {
                            "text": "Tobacco counseling >10 minutes performed",
                            "template": "Tobacco counseling >10 minutes performed"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Follow-up\/Referrals",
            "template": "{children}",
            "children": [
                {
                    "text": "Return visits",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Return visit as needed",
                            "template": "Return visit as needed"
                        },
                        {
                            "text": "Phone follow up in 24 hours",
                            "template": "Phone follow up in 24 hours"
                        },
                        {
                            "text": "Phone follow up in 1 month",
                            "template": "Phone follow up in 1 month"
                        },
                        {
                            "text": "Return visit in 24 hours",
                            "template": "Return visit in 24 hours"
                        },
                        {
                            "text": "Return visit in 2-4 days",
                            "template": "Return visit in 2-4 days"
                        },
                        {
                            "text": "Return visit in 5-7 days",
                            "template": "Return visit in 5-7 days"
                        },
                        {
                            "text": "Return visit in 7-10 days",
                            "template": "Return visit in 7-10 days"
                        },
                        {
                            "text": "Return visit in 2 weeks",
                            "template": "Return visit in 2 weeks"
                        },
                        {
                            "text": "Return visit in 4 weeks",
                            "template": "Return visit in 4 weeks"
                        },
                        {
                            "text": "Return visit in 6 months",
                            "template": "Return visit in 6 months"
                        }
                    ]
                },
                {
                    "text": "Referrals",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Refer to Pulmonary",
                            "template": "Refer to Pulmonary"
                        },
                        {
                            "text": "Refer to Cardiology",
                            "template": "Refer to Cardiology"
                        },
                        {
                            "text": "Refer to smoking cessation support group",
                            "template": "Refer to smoking cessation support group"
                        }
                    ]
                }
            ]
        }
    ]
}