{
    "section": "subjective",
    "templateSet": "Bronchitis",
    "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 bronchitis symptoms",
                    "template": "initial evaluation of bronchitis symptoms"
                },
                {
                    "text": "follow-up bronchitis evaluation",
                    "template": "follow-up bronchitis evaluation"
                },
                {
                    "text": "ongoing bronchitis management",
                    "template": "ongoing bronchitis management"
                },
                {
                    "text": "Visit reason (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Onset\/Time course",
            "template": "Condition onset is {children}.",
            "children": [
                {
                    "text": "acute",
                    "template": "acute"
                },
                {
                    "text": "subacute",
                    "template": "subacute"
                },
                {
                    "text": "chronic",
                    "template": "chronic"
                },
                {
                    "text": "other (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Sx severity",
            "template": "Symptom severity is {children}.",
            "children": [
                {
                    "text": "mild",
                    "template": "mild"
                },
                {
                    "text": "moderate",
                    "template": "moderate"
                },
                {
                    "text": "severe",
                    "template": "severe"
                },
                {
                    "text": "other (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Cough duration",
            "template": "Pt complains of cough x {children}.",
            "children": [
                {
                    "text": "Duration (days)",
                    "template": "{text} days",
                    "type": "number"
                },
                {
                    "text": "Duration (weeks)",
                    "template": "{text} weeks",
                    "type": "number"
                },
                {
                    "text": "Duration (months)",
                    "template": "{text} months",
                    "type": "number"
                },
                {
                    "text": "Duration (years)",
                    "template": "{text} years",
                    "type": "number"
                },
                {
                    "text": "Duration (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Sputum features",
            "template": "Sputum: {children}.",
            "children": [
                {
                    "text": "none",
                    "template": "none"
                },
                {
                    "text": "nonproductive",
                    "template": "nonproductive"
                },
                {
                    "text": "minimal",
                    "template": "minimal"
                },
                {
                    "text": "copious",
                    "template": "copious"
                },
                {
                    "text": "clear",
                    "template": "clear"
                },
                {
                    "text": "white",
                    "template": "white"
                },
                {
                    "text": "yellow",
                    "template": "yellow"
                },
                {
                    "text": "green",
                    "template": "green"
                },
                {
                    "text": "blood-tinged",
                    "template": "blood-tinged"
                },
                {
                    "text": "bloody",
                    "template": "bloody"
                },
                {
                    "text": "pus",
                    "template": "pus"
                },
                {
                    "text": "mucus",
                    "template": "mucus"
                },
                {
                    "text": "plug-shaped",
                    "template": "plug-shaped"
                },
                {
                    "text": "other sputum features (describe)",
                    "template": "{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": "T max (Fahrenheit)",
                    "template": "T max: {text} F.",
                    "type": "number"
                },
                {
                    "text": "fever",
                    "template": "fever",
                    "type": "plus-minus"
                },
                {
                    "text": "productive sputum",
                    "template": "productive sputum",
                    "type": "plus-minus"
                },
                {
                    "text": "nasal congestion\/rhinorrhea",
                    "template": "nasal congestion\/rhinorrhea",
                    "type": "plus-minus"
                },
                {
                    "text": "sneezing",
                    "template": "sneezing",
                    "type": "plus-minus"
                },
                {
                    "text": "dyspnea\/SOB",
                    "template": "dyspnea\/SOB",
                    "type": "plus-minus"
                },
                {
                    "text": "exposure to ill patient",
                    "template": "exposure to ill patient",
                    "type": "plus-minus"
                },
                {
                    "text": "reflux sx",
                    "template": "reflux sx",
                    "type": "plus-minus"
                },
                {
                    "text": "other (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Pertinent positives\/negatives",
            "template": "Pertinent positive\/negative symptoms include {children}.",
            "children": [
                {
                    "text": "T max (Fahrenheit)",
                    "template": "T max: {text} F.",
                    "type": "number"
                },
                {
                    "text": "fever",
                    "template": "fever",
                    "type": "plus-minus"
                },
                {
                    "text": "worse at night",
                    "template": "worse at night",
                    "type": "plus-minus"
                },
                {
                    "text": "clear nasal discharge",
                    "template": "clear nasal discharge",
                    "type": "plus-minus"
                },
                {
                    "text": "purulent nasal discharge",
                    "template": "purulent nasal discharge",
                    "type": "plus-minus"
                },
                {
                    "text": "pleuritic chest pain",
                    "template": "pleuritic chest pain",
                    "type": "plus-minus"
                },
                {
                    "text": "barking\/whoop sound",
                    "template": "barking\/whoop sound",
                    "type": "plus-minus"
                },
                {
                    "text": "post-tussive emesis",
                    "template": "post-tussive emesis",
                    "type": "plus-minus"
                },
                {
                    "text": "conjunctival sx",
                    "template": "conjunctival sx",
                    "type": "plus-minus"
                },
                {
                    "text": "myalgia",
                    "template": "myalgia",
                    "type": "plus-minus"
                },
                {
                    "text": "fatigue\/malaise",
                    "template": "fatigue\/malaise",
                    "type": "plus-minus"
                },
                {
                    "text": "hoarseness",
                    "template": "hoarseness",
                    "type": "plus-minus"
                },
                {
                    "text": "painful swallowing",
                    "template": "painful swallowing",
                    "type": "plus-minus"
                },
                {
                    "text": "R facial pain",
                    "template": "R facial pain",
                    "type": "plus-minus"
                },
                {
                    "text": "L facial pain",
                    "template": "L facial pain",
                    "type": "plus-minus"
                },
                {
                    "text": "halitosis",
                    "template": "halitosis",
                    "type": "plus-minus"
                },
                {
                    "text": "swollen glands",
                    "template": "swollen glands",
                    "type": "plus-minus"
                },
                {
                    "text": "post-tussive emesis",
                    "template": "post-tussive emesis",
                    "type": "plus-minus"
                },
                {
                    "text": "chills",
                    "template": "chills",
                    "type": "plus-minus"
                },
                {
                    "text": "headache",
                    "template": "headache",
                    "type": "plus-minus"
                },
                {
                    "text": "abdominal pain",
                    "template": "abdominal pain",
                    "type": "plus-minus"
                },
                {
                    "text": "rash",
                    "template": "rash",
                    "type": "plus-minus"
                },
                {
                    "text": "night sweats",
                    "template": "night sweats",
                    "type": "plus-minus"
                },
                {
                    "text": "significant weight loss",
                    "template": "significant weight loss",
                    "type": "plus-minus"
                },
                {
                    "text": "heartburn sx",
                    "template": "heartburn sx",
                    "type": "plus-minus"
                },
                {
                    "text": "food\/drink precedes cough",
                    "template": "food\/drink precedes cough"
                },
                {
                    "text": "no relation b\/t food\/drink and cough",
                    "template": "no relationship between food or drink and cough"
                },
                {
                    "text": "other pertinent sx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Medical Hx specific to visit",
            "template": "Previous history includes {children}.",
            "children": [
                {
                    "text": "chronic bronchitis",
                    "template": "chronic bronchitis",
                    "type": "plus-minus"
                },
                {
                    "text": "asthma",
                    "template": "asthma",
                    "type": "plus-minus"
                },
                {
                    "text": "COPD",
                    "template": "COPD",
                    "type": "plus-minus"
                },
                {
                    "text": "allergy\/hayfever",
                    "template": "allergy\/hayfever",
                    "type": "plus-minus"
                },
                {
                    "text": "ACE inhibitor use",
                    "template": "ACE inhibitor use",
                    "type": "plus-minus"
                },
                {
                    "text": "beta-blocker drug use",
                    "template": "beta-blocker drug use",
                    "type": "plus-minus"
                },
                {
                    "text": "GE reflux",
                    "template": "GE reflux",
                    "type": "plus-minus"
                },
                {
                    "text": "reflux surgery",
                    "template": "reflux surgery",
                    "type": "plus-minus"
                },
                {
                    "text": "heart failure",
                    "template": "heart failure",
                    "type": "plus-minus"
                },
                {
                    "text": "diabetes type 1",
                    "template": "diabetes type 1",
                    "type": "plus-minus"
                },
                {
                    "text": "diabetes type 2",
                    "template": "diabetes type 2",
                    "type": "plus-minus"
                },
                {
                    "text": "alcoholism",
                    "template": "alcoholism",
                    "type": "plus-minus"
                },
                {
                    "text": "hospitalized in last year",
                    "template": "hospitalization within past year",
                    "type": "plus-minus"
                },
                {
                    "text": "recent immunosuppressant use",
                    "template": "recent immunosuppressant use",
                    "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": "malignancy",
                    "template": "malignancy",
                    "type": "plus-minus"
                },
                {
                    "text": "S\/P splenectomy",
                    "template": "S\/P splenectomy",
                    "type": "plus-minus"
                },
                {
                    "text": "neuromuscular disease",
                    "template": "neuromuscular disease",
                    "type": "plus-minus"
                },
                {
                    "text": "Hx immunodeficiency",
                    "template": "Hx {text}",
                    "type": "alpha"
                },
                {
                    "text": "Environ\/Work\/Travel exposure (describe)",
                    "template": "exposures: {text}",
                    "type": "alpha"
                },
                {
                    "text": "other medical Hx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Smoking status",
            "template": "Smoking status: {children}.",
            "children": [
                {
                    "text": "nonsmoker",
                    "template": "nonsmoker"
                },
                {
                    "text": "tobacco abuse",
                    "template": "tobacco abuse",
                    "type": "plus-minus"
                },
                {
                    "text": "tobacco dependence",
                    "template": "tobacco dependence",
                    "type": "plus-minus"
                },
                {
                    "text": "tobacco products used",
                    "template": "tobacco products used include {children}",
                    "children": [
                        {
                            "text": "cigarettes",
                            "template": "cigarettes"
                        },
                        {
                            "text": "cigars",
                            "template": "cigars"
                        },
                        {
                            "text": "pipes",
                            "template": "pipes"
                        },
                        {
                            "text": "water pipes",
                            "template": "water pipes"
                        },
                        {
                            "text": "chew",
                            "template": "chew"
                        },
                        {
                            "text": "snuff",
                            "template": "snuff"
                        }
                    ]
                },
                {
                    "text": "packs per day (specify)",
                    "template": "{text} packs per day",
                    "type": "number"
                },
                {
                    "text": "age at smoking onset (specify)",
                    "template": "started smoking at age {text}",
                    "type": "number"
                },
                {
                    "text": "smoking duration (months)",
                    "template": "smoking duration is {text} months",
                    "type": "number"
                },
                {
                    "text": "smoking duration (years)",
                    "template": "smoking duration is {text} years",
                    "type": "number"
                },
                {
                    "text": "tobacco withdrawal",
                    "template": "tobacco withdrawal",
                    "type": "plus-minus"
                },
                {
                    "text": "tobacco remission",
                    "template": "tobacco remission",
                    "type": "plus-minus"
                },
                {
                    "text": "hx of nicotine dependence (describe)",
                    "template": "{text}",
                    "type": "alpha"
                },
                {
                    "text": "second hand smoke type\/exposure (describe)",
                    "template": "{text}",
                    "type": "alpha"
                },
                {
                    "text": "other (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Immunizations",
            "template": "Immunization Hx: {children}.",
            "children": [
                {
                    "text": "flu vaccine received this season",
                    "template": "flu vaccine received this season",
                    "type": "plus-minus"
                },
                {
                    "text": "pneumococcal vaccine Hx",
                    "template": "pneumococcal vaccine Hx",
                    "type": "plus-minus"
                },
                {
                    "text": "meningococcal vaccine Hx",
                    "template": "meningococcal vaccine Hx",
                    "type": "plus-minus"
                },
                {
                    "text": "Pertussis vaccine",
                    "template": "pertussis vaccine is {children}",
                    "children": [
                        {
                            "text": "up to date",
                            "template": "up to date"
                        },
                        {
                            "text": "not up to date",
                            "template": "not up to date"
                        }
                    ]
                },
                {
                    "text": "other immunizations (specify)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        }
    ]
}