HEENT Exam
Head: {formmenu: default=Normocephalic; default=Atraumatic; Not Examined; Other; multiple=yes; name=Head; cols=30}.{if: contains(head, "Other")}
Other:{formtext: cols=50; name=HeadNote}{else}{endif}
{formtoggle: name=Eyes; default=yes}Eyes: {formmenu: default=EOM intact; anicteric; 1; 2; Other; ; name=Eye1; multiple=yes}. {formmenu: default=No scleral injection; R scleral injection; L scleral injection; B/L scleral injection; No scleral injection; Other; ; name=Eye2; multiple=yes}. {formmenu: R lateral strabismus; R medial strabismus; L lateral strabismus; L medial strabismus; Other; ; default=No strabismus noted; name=Eye3; multiple=yes}.{if: contains(concat(Eye1, Eye2, Eye3),"Other")}
Other:{formtext: cols=45; name=EyeNote}{else}{endif}{endformtoggle}
{formtoggle: name=Ears; default=yes}Ears: {formmenu: R canal\ ; L canal\ ; default=B/L canals\ }{formmenu: default=clear with mild/mod cerumen; erythematous; erythematous and swollen; purulent drainage; foreign body noted; Other; name=Ear1; multiple=yes; cols=30}, {formmenu: R TM\ ; L TM\ ; default=B/L TM\ }{formmenu: default=intact and noninflamed; bright red and bulging\ ; Other; name=Ear2; multiple=yes}.{if: contains(concat(ear1, ear2),"Other")}Other:{formtext: cols=45; name=EarNote}{else}{endif}{endformtoggle}
{formtoggle: name=Nose; default=yes}Nose: Nares {formmenu: default=patent; obstructed with clear drainage; obstructed with purulent drainage; obstructed with blood; Other; name=Nose1; multiple=yes}, {formmenu: R Turbinate; L Turbinate; default=B/L Turbinates} {formmenu: default=WNL; erythematous and swollen; erythematous and swollen with clean mucus; erythematous and swollen with yellow/green mucus; Not visualized; Other; name=Nose2; multiple=yes}
{if: contains(concat(Nose1, Nose2),"Other")}Other:{formtext: cols=50; name=NoseNote}{else}{endif}{endformtoggle}{formtoggle: name=Throat; default=yes}Throat: {formmenu: default=Oral cavity and pharynx normal.\ ; No inflammation, swelling, exudate, or lesions.\ ; Uvula swollen; Other\ ; Lesion noted; Gingival swelling; Pharyngeal cobblestoning; Erythema; Post nasal drainage; ; name=Throat1; cols=50; multiple=yes}{formtoggle: name=; default=yes}Tonsils: {formmenu: Absent; R\ ; L\ ; default=B/L\ ; Other; name=Tonsil1}{if: contains(tonsil1, "Absent")}{else}{formmenu: default=WNL; erythematous; swollen; with white exudate; tonsil stones evident; Other; ; multiple=yes; name=Tonsil2}{endif}{endformtoggle}{if: contains(concat(throat1, tonsil1,tonsil2),"Other")}Other:{formtext: cols=50; name=ThroatNote}{else}{endif}{endformtoggle}
{formtoggle: name=Dentition; default=yes}Dentition: {formmenu: default=Teeth and gingiva in good general condition.; Dentures; Poor dentition; Gingival swelling; Other; ; name=Dentition1; multiple=yes}
{if: contains(dentition1,"Other")}Other:{formtext: cols=45; name=DentitionNote}{else}{endif}{endformtoggle}
{formparagraph: name=HEENT Notes; cols=50; rows=2; default=}