{% capture childItems %}{% if QuestionnaireResponse.item.where(linkId = 'questionnaire').exists() %}{% for currentItem in QuestionnaireResponse.item.where(linkId = 'questionnaire') %}* indicates required field
{% capture childItems %}{% if currentItem.item.where(linkId = 'section54392738').exists() %}Additional Patient Information
{% for currentItem in currentItem.item.where(linkId = 'section54392738') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'ax_language' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'ax_language' and answer.exists()) %}{% if currentItem.answer.exists() %}{% capture answer %}{% for answer in currentItem.answer %}{% if answer.value.code = 'English' %}English{% endif %}{% if answer.value.code = 'Cantonese' %}Cantonese{% endif %}{% if answer.value.code = 'Mandarin' %}Mandarin{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endcapture %}Language: {{answer}}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item66127845' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item66127845' and answer.exists()) %}{% if currentItem.answer.exists() %}Preferred Site: {% for answer in currentItem.answer %}{% if answer.value.code = 'No Preference' %}No Preference{% endif %}{% if answer.value.code = 'Richmond Hill' %}Richmond Hill{% endif %}{% if answer.value.code = 'Scarborough' %}Scarborough{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}
{% else %}
{% endif %}{% endif %}{% endfor %}
{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'patientInformationSection').exists() %}Referral Information {% for currentItem in currentItem.item.where(linkId = 'patientInformationSection') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'diabetesType' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'diabetesType' and answer.exists()) %}{% if currentItem.answer.exists() %}Diabetes Type: {% for answer in currentItem.answer %}{% if answer.value.code = 'Type 2 Diabetes' %}Type 2 Diabetes{% endif %}{% if answer.value.code = 'Pre-Diabetes' %}Pre-Diabetes{% endif %}{% if answer.value.code = 'At Risk' %}At Risk{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'diagnosisAcuity' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'diagnosisAcuity' and answer.exists()) %}{% if currentItem.answer.exists() %}Duration of diagnosis: {% for answer in currentItem.answer %}{% if answer.value.code = 'New (<6 months)' %}New (<6 months){% endif %}{% if answer.value.code = 'Established (>6 months)' %}Established (>6 months){% endif %}{% endfor %}{% endif %}{% endfor %}
$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}
{% else %}
{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section25948514').exists() %}Service(s) Requested/Reason for Referral {% for currentItem in currentItem.item.where(linkId = 'section25948514') %}Select all that apply:
{% capture childItems %}{% if currentItem.item.where(linkId = 'item76597097' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item76597097' and answer.exists(value.ofType(boolean)=true)) %}Nutrition and Lifestyle Counselling{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item93032788' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item93032788' and answer.exists(value.ofType(boolean)=true)) %}Foot Screening{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item84430472' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item84430472' and answer.exists(value.ofType(boolean)=true)) %}Glucometer/ Flash Glucose Monitoring System Teaching{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item90036939' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item90036939' and answer.exists(value.ofType(boolean)=true)) %}Insulin Initiation{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section69126798').exists() %} {% for currentItem in currentItem.item.where(linkId = 'section69126798') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item49066272' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item49066272' and answer.exists()) %}{% if currentItem.answer.exists() %}Insulin Type: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item2940501' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item2940501' and answer.exists()) %}{% if currentItem.answer.exists() %}Insulin dose and time: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}{% if %resource.repeat(item).where(linkId='item49444401').answer.empty() %}
{% if %resource.repeat(item).where(linkId='item49444401').answer.empty() %}Diabetes educator to teach patient: insulin dose adjustment by 1-2 units or 10-20% of total daily dose as appropriate.{% endif %}{% endif %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item49444401' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item49444401' and answer.exists()) %}{% if currentItem.answer.exists() %}Comments: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}
{% else %}
{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item88820032' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item88820032' and answer.exists(value.ofType(boolean)=true)) %}Insulin Review{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section84443654').exists() %} {% for currentItem in currentItem.item.where(linkId = 'section84443654') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item86370967' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item86370967' and answer.exists()) %}{% if currentItem.answer.exists() %}Insulin type: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item15694571' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item15694571' and answer.exists()) %}{% if currentItem.answer.exists() %}Insulin dose and time: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}{% if %resource.repeat(item).where(linkId='item46409807').answer.empty() %}
{% if %resource.repeat(item).where(linkId='item46409807').answer.empty() %}Diabetes educator to teach patient: insulin dose adjustment by 1-2 units or 10-20% of total daily dose as appropriate.{% endif %}{% endif %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item46409807' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item46409807' and answer.exists()) %}{% if currentItem.answer.exists() %}Comments: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}
{% else %}
{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item93616553' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item93616553' and answer.exists(value.ofType(boolean)=true)) %}GLP-1 Initiation{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section12645338').exists() %} {% for currentItem in currentItem.item.where(linkId = 'section12645338') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item65502346' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item65502346' and answer.exists()) %}{% if currentItem.answer.exists() %}Type: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item98682076' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item98682076' and answer.exists()) %}{% if currentItem.answer.exists() %}Dose & Time: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item92523489' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item92523489' and answer.exists()) %}{% if currentItem.answer.exists() %}Comments: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}
{% else %}
{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item91333221' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item91333221' and answer.exists(value.ofType(boolean)=true)) %}GLP-1 Review{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section89575935').exists() %} {% for currentItem in currentItem.item.where(linkId = 'section89575935') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item42590803' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item42590803' and answer.exists()) %}{% if currentItem.answer.exists() %}Type: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item82165747' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item82165747' and answer.exists()) %}{% if currentItem.answer.exists() %}Dose & Time: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item68490745' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item68490745' and answer.exists()) %}{% if currentItem.answer.exists() %}Comments: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}
{% else %}
{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item61998839' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item61998839' and answer.exists(value.ofType(boolean)=true)) %}Referral to Social Worker at Carefirst Diabetes Education Program{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item4180826' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item4180826' and answer.exists(value.ofType(boolean)=true)) %}Endocrinologist Consult (if available on site){% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}
{% else %}
{% endif %}{% endif %}{% endfor %}
{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section89867293').exists() %}Clinical Information
{% for currentItem in currentItem.item.where(linkId = 'section89867293') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'section43618734').exists() %}Relevant Medical History
{% for currentItem in currentItem.item.where(linkId = 'section43618734') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item91541128' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item91541128' and answer.exists(value.ofType(boolean)=true)) %}Hypertension{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item6554969' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item6554969' and answer.exists(value.ofType(boolean)=true)) %}Nephropathy{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item50650995' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item50650995' and answer.exists(value.ofType(boolean)=true)) %}Dyslipidemia{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item77998616' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item77998616' and answer.exists(value.ofType(boolean)=true)) %}Exercise restrictions{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item98913171' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item98913171' and answer.exists(value.ofType(boolean)=true)) %}CAD{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item74309838' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item74309838' and answer.exists(value.ofType(boolean)=true)) %}Retinopathy{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item89731593' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item89731593' and answer.exists(value.ofType(boolean)=true)) %}Obesity{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item13585452' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item13585452' and answer.exists(value.ofType(boolean)=true)) %}PAD{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item38016186' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item38016186' and answer.exists(value.ofType(boolean)=true)) %}Neuropathy{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item42057249' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item42057249' and answer.exists(value.ofType(boolean)=true)) %}Foot problems{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'cm_mentalHealth' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'cm_mentalHealth' and answer.exists()) %}{% if currentItem.answer.exists() %}Psychosocial: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'hxOther' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'hxOther' and answer.exists()) %}{% if currentItem.answer.exists() %}Other: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section83252400').exists() %}Current Medications {% for currentItem in currentItem.item.where(linkId = 'section83252400') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item68855638' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item68855638' and answer.exists(value.ofType(boolean)=true)) %}None{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section50744744').exists() %}{% for currentItem in currentItem.item.where(linkId = 'section50744744') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item30369286' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item30369286' and answer.exists(value.ofType(boolean)=true)) %}Oral Hypoglycemic Agents{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item17146365' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item17146365' and answer.exists(value.ofType(boolean)=true)) %}ACEi/ARB{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item89954867' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item89954867' and answer.exists(value.ofType(boolean)=true)) %}Statin{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item91202442' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item91202442' and answer.exists(value.ofType(boolean)=true)) %}Insulin/GLP-1 analog{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item28596480' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item28596480' and answer.exists()) %}{% if currentItem.answer.exists() %}{% capture answer %}{% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endcapture %}Other: {{answer}}{% endif %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}
{% else %}
{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}
{% else %}
{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}
{% else %}
{% endif %}{% endif %}{% endfor %}
{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section61428617').exists() %}Cumulative Patient Profile
{% for currentItem in currentItem.item.where(linkId = 'section61428617') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'CPPAttachment' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'CPPAttachment' and answer.exists(value.ofType(boolean)=true)) %}CPP Attached Separately{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section58148321').exists() %}{% for currentItem in currentItem.item.where(linkId = 'section58148321') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'prob' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'prob' and answer.exists()) %}{% if currentItem.answer.exists() %}Current Problems: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item19532475' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item19532475' and answer.exists()) %}{% if currentItem.answer.exists() %}Allergies: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'rx' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'rx' and answer.exists()) %}{% if currentItem.answer.exists() %}Current Medications: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'pmhx' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'pmhx' and answer.exists()) %}{% if currentItem.answer.exists() %}Past Medical History: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item68613367' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item68613367' and answer.exists()) %}{% if currentItem.answer.exists() %}Family History: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}
{% else %}
{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}
{% else %}
{% endif %}{% endif %}{% endfor %}
{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section55489124').exists() %}Additional Information / Comments: {% for currentItem in currentItem.item.where(linkId = 'section55489124') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item35752766' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item35752766' and answer.exists()) %}{% if currentItem.answer.exists() %} {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}
{% else %}
{% endif %}{% endif %}{% endfor %}
{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section79119148').exists() %}Supporting Documentation
{% for currentItem in currentItem.item.where(linkId = 'section79119148') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item89395197' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item89395197' and answer.exists(value.ofType(boolean)=true)) %}Lab report including A1C completed within the last 3-6 months, and latest lipid profile, renal function and ACR attached{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}
{% else %}
{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}
{% else %}
{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}
{% else %}
{% endif %}{% endif %}{% endfor %}