{% capture childItems %}{% if QuestionnaireResponse.item.where(linkId = 's').exists() %}{% for currentItem in QuestionnaireResponse.item.where(linkId = 's') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'section49999867').exists() %}Consent
{% for currentItem in currentItem.item.where(linkId = 'section49999867') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item37335906' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item37335906' and answer.exists()) %}{% if currentItem.answer.exists() %}Client is aware of and consented to this referral: {% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% 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 = 'section3264854').exists() %}STOP
{% for currentItem in currentItem.item.where(linkId = 'section3264854') %}{% capture childItems %}{% 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 = 'section38273739').exists() %}Program Referral Criteria
{% for currentItem in currentItem.item.where(linkId = 'section38273739') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item1967164' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item1967164' and answer.exists()) %}{% if currentItem.answer.exists() %}Is the client 18 years of age or older: {% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section39613765').exists() %}Please Note
{% for currentItem in currentItem.item.where(linkId = 'section39613765') %}{% capture childItems %}{% 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 = 'section12847616').exists() %}Inclusion Criteria
{% for currentItem in currentItem.item.where(linkId = 'section12847616') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item49714327' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item49714327' and answer.exists()) %}{% if currentItem.answer.exists() %}Client has a main concern of anxiety, depression, or anxiety-related problem (e.g. post-traumatic stress, health anxiety, work stress, obsessive-compulsive concerns): {% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% 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 = 'section72429917').exists() %}STOP
{% for currentItem in currentItem.item.where(linkId = 'section72429917') %}{% capture childItems %}{% 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 = 'section86254334').exists() %}Exclusionary Criteria
{% for currentItem in currentItem.item.where(linkId = 'section86254334') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item76121425' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item76121425' and answer.exists()) %}{% if currentItem.answer.exists() %}The client is actively suicidal and with impaired coping skills and/or has attempted suicide in the past 6 months: {% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section54495467').exists() %}STOP
{% for currentItem in currentItem.item.where(linkId = 'section54495467') %}{% capture childItems %}{% 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 = 'item1990858' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item1990858' and answer.exists()) %}{% if currentItem.answer.exists() %}The client poses a high risk to themselves, risk to others or is at significant risk of severe self-neglect: {% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section95021338').exists() %}STOP
{% for currentItem in currentItem.item.where(linkId = 'section95021338') %}{% capture childItems %}{% 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 = 'item456132' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item456132' and answer.exists()) %}{% if currentItem.answer.exists() %}The client is self-harming, which is the immediate, primary concern: {% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section21890674').exists() %}STOP
{% for currentItem in currentItem.item.where(linkId = 'section21890674') %}{% capture childItems %}{% 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 = 'item85478952' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item85478952' and answer.exists()) %}{% if currentItem.answer.exists() %}The client is experiencing significant symptoms of mania or hypomania currently or has experienced these symptoms within the past year. (not due to medication/substance use): {% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section97698246').exists() %}STOP
{% for currentItem in currentItem.item.where(linkId = 'section97698246') %}{% capture childItems %}{% 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 = 'item35961598' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item35961598' and answer.exists()) %}{% if currentItem.answer.exists() %}The client is experiencing significant symptoms of a psychotic disorder currently or has experienced these symptoms within the past year (not due to medication/substance use): {% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section14136581').exists() %}STOP
{% for currentItem in currentItem.item.where(linkId = 'section14136581') %}{% capture childItems %}{% 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 = 'item4954473' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item4954473' and answer.exists()) %}{% if currentItem.answer.exists() %}The client has a severe/complex personality disorder that would impact their ability to actively participate in CBT for anxiety or depression: {% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section10441379').exists() %}STOP
{% for currentItem in currentItem.item.where(linkId = 'section10441379') %}{% capture childItems %}{% 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 = 'item7249653' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item7249653' and answer.exists()) %}{% if currentItem.answer.exists() %}The client has exclusively requested medication management: {% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section90430589').exists() %}STOP
{% for currentItem in currentItem.item.where(linkId = 'section90430589') %}{% capture childItems %}{% 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 = 'item92961042' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item92961042' and answer.exists()) %}{% if currentItem.answer.exists() %}The client has moderate to severe impairment of cognitive function (e.g., dementia); or moderate to severe impairment due to a developmental disability or learning disability: {% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section6252983').exists() %}STOP
{% for currentItem in currentItem.item.where(linkId = 'section6252983') %}{% capture childItems %}{% 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 = 'item67161689' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item67161689' and answer.exists()) %}{% if currentItem.answer.exists() %}The client currently has problematic substance use or has had problematic substance use in the past three months that would seriously impact their ability to actively participate in CBT (e.g., the client is unable to attend scheduled session, or unable to attempt assigned work required between sessions): {% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section54876940').exists() %}STOP
{% for currentItem in currentItem.item.where(linkId = 'section54876940') %}{% capture childItems %}{% 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 = 'item23443648' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item23443648' and answer.exists()) %}{% if currentItem.answer.exists() %}Client requires specialized concurrent disorders treatment: {% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section19600218').exists() %}STOP
{% for currentItem in currentItem.item.where(linkId = 'section19600218') %}{% capture childItems %}{% 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 = 'item29163757' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item29163757' and answer.exists()) %}{% if currentItem.answer.exists() %}Client has a severe eating disorder that would impact their ability to actively participate in CBT for anxiety or depression: {% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section55142452').exists() %}STOP
{% for currentItem in currentItem.item.where(linkId = 'section55142452') %}{% capture childItems %}{% 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 = 'section44914524').exists() %}{% for currentItem in currentItem.item.where(linkId = 'section44914524') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'section33974133').exists() %}Client Information
{% for currentItem in currentItem.item.where(linkId = 'section33974133') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item7989770' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item7989770' and answer.exists()) %}{% if currentItem.answer.exists() %}Email: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item29976128' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item29976128' and answer.exists(value.ofType(boolean)=true)) %}Patient does not have an email address{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'ptnt_cntctPrfrnc' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'ptnt_cntctPrfrnc' and answer.exists()) %}{% if currentItem.answer.exists() %}Preferred method of contact: {% for answer in currentItem.answer %}{% if answer.value.code = 'Mobile' %}Mobile{% endif %}{% if answer.value.code = 'Home' %}Home{% endif %}{% if answer.value.code = 'Work' %}Work{% endif %}{% if answer.value.code = 'Email' %}Email{% endif %}{% if answer.value.code = 'Text' %}Text{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item32218804' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item32218804' and answer.exists()) %}{% if currentItem.answer.exists() %}Permission to leave a voicemail: {% for answer in currentItem.answer %}{% if answer.value.code = 'No' %}No{% endif %}{% if answer.value.code = 'Yes' %}Yes{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'ptnt_cntctCnsnt' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'ptnt_cntctCnsnt' and answer.exists()) %}{% if currentItem.answer.exists() %}Permission to speak with their parent/guardian/family member: {% for answer in currentItem.answer %}{% if answer.value.code = 'No' %}No{% endif %}{% if answer.value.code = 'Yes' %}Yes{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item40054684' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item40054684' and answer.exists()) %}{% if currentItem.answer.exists() %}Preferred time of contact (core business hours are 8:30-4:30 PM with some evening and weekend availability): {% for answer in currentItem.answer %}{% if answer.value.code = 'Morning' %}Morning{% endif %}{% if answer.value.code = 'Afternoon' %}Afternoon{% endif %}{% if answer.value.code = 'Evening' %}Evening{% endif %}{% if answer.value.code = 'Unsure' %}Unsure{% endif %}{% if answer.value.code = 'Any' %}Any{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item46487425' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item46487425' and answer.exists()) %}{% if currentItem.answer.exists() %}Does the client require an interpreter: {% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item97047215' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item97047215' and answer.exists()) %}{% if currentItem.answer.exists() %}Language: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item17977898' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item17977898' and answer.exists()) %}{% if currentItem.answer.exists() %}{% capture answer %}{% for answer in currentItem.answer %}{% if answer.value.code = 'CMHA Worker' %}CMHA Worker{% endif %}{% if answer.value.code = 'Event' %}Event{% endif %}{% if answer.value.code = 'Existing Client' %}Existing Client{% endif %}{% if answer.value.code = 'Website' %}Website{% endif %}{% if answer.value.code = 'Search Engine (Google, Yahoo, etc.)' %}Search Engine (Google, Yahoo, etc.){% endif %}{% if answer.value.code = 'Transit Advertisements' %}Transit Advertisements{% endif %}{% endfor %}{% endcapture %}How did you hear about the OSP program: {{answer}}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section22204334').exists() %}Support Organizations {% for currentItem in currentItem.item.where(linkId = 'section22204334') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'section52454146').exists() %}{% for currentItem in currentItem.item.where(linkId = 'section52454146') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item38042256' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item38042256' and answer.exists(value.ofType(boolean)=true)) %}Across Boundaries{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item2629219' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item2629219' and answer.exists(value.ofType(boolean)=true)) %}Hong Fook Mental Health Association{% 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 = 'item35282384' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item35282384' and answer.exists(value.ofType(boolean)=true)) %}Client is not with any of the agencies listed above{% 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 = 'section41558688').exists() %}Primary Care Provider
{% for currentItem in currentItem.item.where(linkId = 'section41558688') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item30583415' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item30583415' and answer.exists()) %}{% if currentItem.answer.exists() %}{% if currentItem.answer.value.ofType(Coding).code = 'Y' %}Referring provider is Primary Care Provider{% elsif currentItem.answer.value.ofType(Coding).code = 'N' %}Referring provider is NOT Primary Care Provider{% endif %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item73714162' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item73714162' and answer.exists(value.ofType(boolean)=true)) %}Client does not have a primary care provider (PCP){% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section60358726').exists() %}{% for currentItem in currentItem.item.where(linkId = 'section60358726') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item86194914' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item86194914' and answer.exists()) %}{% if currentItem.answer.exists() %}PCP Name: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item93996427' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item93996427' and answer.exists()) %}{% if currentItem.answer.exists() %}Email: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item31723932' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item31723932' and answer.exists()) %}{% if currentItem.answer.exists() %}Professional ID: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item34994179' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item34994179' and answer.exists()) %}{% if currentItem.answer.exists() %}OHIP Billing #: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item58543877' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item58543877' and answer.exists()) %}{% if currentItem.answer.exists() %}Clinic Name: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item91721567' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item91721567' and answer.exists()) %}{% if currentItem.answer.exists() %}Address: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item35304545' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item35304545' and answer.exists()) %}{% if currentItem.answer.exists() %}Address Line 2: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item1621758' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item1621758' and answer.exists()) %}{% if currentItem.answer.exists() %}City: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item91112457' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item91112457' and answer.exists()) %}{% if currentItem.answer.exists() %}Postal Code: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item26155675' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item26155675' and answer.exists()) %}{% if currentItem.answer.exists() %}Phone Number: {% for answer in currentItem.answer %}{{ answer.value.ofType(integer) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item82276690' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item82276690' and answer.exists()) %}{% if currentItem.answer.exists() %}Fax Number: {% for answer in currentItem.answer %}{{ answer.value.ofType(integer) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item25608239' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item25608239' and answer.exists()) %}{% if currentItem.answer.exists() %}Other Information: {% 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 = 'item40132366' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item40132366' and answer.exists()) %}{% if currentItem.answer.exists() %}Has the client provided consent to share information with the Primary Care Provider: {% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% endif %}{% if answer.value.code = 'NotSure' %}Not sure{% 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 %}{% 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 = 'section85250608').exists() %}PHQ-9
{% for currentItem in currentItem.item.where(linkId = 'section85250608') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item65955818' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item65955818' and answer.exists()) %}{% if currentItem.answer.exists() %}{% capture answer %}{% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endcapture %}PHQ-9 Score: {{answer}}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'patient_health_quest').exists() %}{% for currentItem in currentItem.item.where(linkId = 'patient_health_quest') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'phq9Q').exists() %}Over the last two weeks:
{% for currentItem in currentItem.item.where(linkId = 'phq9Q') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'q1' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'q1' and answer.exists()) %}{% if currentItem.answer.exists() %}1. Little interest or pleasure in doing things {% for answer in currentItem.answer %}{% if answer.value.code = 'Not at all' %}Not at all{% endif %}{% if answer.value.code = 'Several days' %}Several days{% endif %}{% if answer.value.code = 'More than half the days' %}More than half the days{% endif %}{% if answer.value.code = 'Nearly every day' %}Nearly every day{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'q2' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'q2' and answer.exists()) %}{% if currentItem.answer.exists() %}2. Feeling down, depressed, or hopeless {% for answer in currentItem.answer %}{% if answer.value.code = 'Not at all' %}Not at all{% endif %}{% if answer.value.code = 'Several days' %}Several days{% endif %}{% if answer.value.code = 'More than half the days' %}More than half the days{% endif %}{% if answer.value.code = 'Nearly every day' %}Nearly every day{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'q3' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'q3' and answer.exists()) %}{% if currentItem.answer.exists() %}3. Trouble falling or staying asleep, or sleeping too much {% for answer in currentItem.answer %}{% if answer.value.code = 'Not at all' %}Not at all{% endif %}{% if answer.value.code = 'Several days' %}Several days{% endif %}{% if answer.value.code = 'More than half the days' %}More than half the days{% endif %}{% if answer.value.code = 'Nearly every day' %}Nearly every day{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'q4' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'q4' and answer.exists()) %}{% if currentItem.answer.exists() %}4. Feeling tired or having little energy {% for answer in currentItem.answer %}{% if answer.value.code = 'Not at all' %}Not at all{% endif %}{% if answer.value.code = 'Several days' %}Several days{% endif %}{% if answer.value.code = 'More than half the days' %}More than half the days{% endif %}{% if answer.value.code = 'Nearly every day' %}Nearly every day{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'q5' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'q5' and answer.exists()) %}{% if currentItem.answer.exists() %}5. Poor appetite or overeating {% for answer in currentItem.answer %}{% if answer.value.code = 'Not at all' %}Not at all{% endif %}{% if answer.value.code = 'Several days' %}Several days{% endif %}{% if answer.value.code = 'More than half the days' %}More than half the days{% endif %}{% if answer.value.code = 'Nearly every day' %}Nearly every day{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'q6' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'q6' and answer.exists()) %}{% if currentItem.answer.exists() %}6. Feeling bad about yourself - or that you are a failure or have let yourself or your family down {% for answer in currentItem.answer %}{% if answer.value.code = 'Not at all' %}Not at all{% endif %}{% if answer.value.code = 'Several days' %}Several days{% endif %}{% if answer.value.code = 'More than half the days' %}More than half the days{% endif %}{% if answer.value.code = 'Nearly every day' %}Nearly every day{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'q7' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'q7' and answer.exists()) %}{% if currentItem.answer.exists() %}7. Trouble concentrating on things, such as reading the newspaper or watching television {% for answer in currentItem.answer %}{% if answer.value.code = 'Not at all' %}Not at all{% endif %}{% if answer.value.code = 'Several days' %}Several days{% endif %}{% if answer.value.code = 'More than half the days' %}More than half the days{% endif %}{% if answer.value.code = 'Nearly every day' %}Nearly every day{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'q8' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'q8' and answer.exists()) %}{% if currentItem.answer.exists() %}8. Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual {% for answer in currentItem.answer %}{% if answer.value.code = 'Not at all' %}Not at all{% endif %}{% if answer.value.code = 'Several days' %}Several days{% endif %}{% if answer.value.code = 'More than half the days' %}More than half the days{% endif %}{% if answer.value.code = 'Nearly every day' %}Nearly every day{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'q9' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'q9' and answer.exists()) %}{% if currentItem.answer.exists() %}9. Thoughts that you would be better off dead, or of hurting yourself in some way {% for answer in currentItem.answer %}{% if answer.value.code = 'Not at all' %}Not at all{% endif %}{% if answer.value.code = 'Several days' %}Several days{% endif %}{% if answer.value.code = 'More than half the days' %}More than half the days{% endif %}{% if answer.value.code = 'Nearly every day' %}Nearly every day{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'q10' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'q10' and answer.exists()) %}{% if currentItem.answer.exists() %}10. If you indicated any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people {% for answer in currentItem.answer %}"{% if answer.value.code = 'Not difficult at all' %}Not difficult at all{% endif %}{% if answer.value.code = 'Somewhat difficult' %}Somewhat difficult{% endif %}{% if answer.value.code = 'Very difficult' %}Very difficult{% endif %}{% if answer.value.code = 'Extremely difficult' %}Extremely difficult{% 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 %}{% 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 %}
PHQ-9 Score: {{answer}}{% 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 = 'section702092').exists() %}GAD-7
{% for currentItem in currentItem.item.where(linkId = 'section702092') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item10370323' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item10370323' and answer.exists()) %}{% if currentItem.answer.exists() %}GAD-7 Score: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'gad_7').exists() %}{% for currentItem in currentItem.item.where(linkId = 'gad_7') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'gad7Qs').exists() %}Over the last 2 weeks:
{% for currentItem in currentItem.item.where(linkId = 'gad7Qs') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'gad7q1' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'gad7q1' and answer.exists()) %}{% if currentItem.answer.exists() %}1. Feeling nervous, anxious, or on edge {% for answer in currentItem.answer %}"{% if answer.value.code = 'Not at all' %}Not at all{% endif %}{% if answer.value.code = 'Several days' %}Several days{% endif %}{% if answer.value.code = 'Over half the days' %}Over half the days{% endif %}{% if answer.value.code = 'Nearly every day' %}Nearly every day{% endif %}"{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'gad7q2' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'gad7q2' and answer.exists()) %}{% if currentItem.answer.exists() %}2. Not being able to stop or control worrying {% for answer in currentItem.answer %}"{% if answer.value.code = 'Not at all' %}Not at all{% endif %}{% if answer.value.code = 'Several days' %}Several days{% endif %}{% if answer.value.code = 'Over half the days' %}Over half the days{% endif %}{% if answer.value.code = 'Nearly every day' %}Nearly every day{% endif %}"{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'gad7q3' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'gad7q3' and answer.exists()) %}{% if currentItem.answer.exists() %}3. Worrying too much about different things {% for answer in currentItem.answer %}"{% if answer.value.code = 'Not at all' %}Not at all{% endif %}{% if answer.value.code = 'Several days' %}Several days{% endif %}{% if answer.value.code = 'Over half the days' %}Over half the days{% endif %}{% if answer.value.code = 'Nearly every day' %}Nearly every day{% endif %}"{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'gad7q4' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'gad7q4' and answer.exists()) %}{% if currentItem.answer.exists() %}4. Trouble relaxing {% for answer in currentItem.answer %}"{% if answer.value.code = 'Not at all' %}Not at all{% endif %}{% if answer.value.code = 'Several days' %}Several days{% endif %}{% if answer.value.code = 'Over half the days' %}Over half the days{% endif %}{% if answer.value.code = 'Nearly every day' %}Nearly every day{% endif %}"{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'gad7q5' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'gad7q5' and answer.exists()) %}{% if currentItem.answer.exists() %}5. Being so restless that it's hard to sit still {% for answer in currentItem.answer %}"{% if answer.value.code = 'Not at all' %}Not at all{% endif %}{% if answer.value.code = 'Several days' %}Several days{% endif %}{% if answer.value.code = 'Over half the days' %}Over half the days{% endif %}{% if answer.value.code = 'Nearly every day' %}Nearly every day{% endif %}"{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'gad7q6' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'gad7q6' and answer.exists()) %}{% if currentItem.answer.exists() %}6. Becoming easily annoyed or irritable {% for answer in currentItem.answer %}"{% if answer.value.code = 'Not at all' %}Not at all{% endif %}{% if answer.value.code = 'Several days' %}Several days{% endif %}{% if answer.value.code = 'Over half the days' %}Over half the days{% endif %}{% if answer.value.code = 'Nearly every day' %}Nearly every day{% endif %}"{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'gad7q7' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'gad7q7' and answer.exists()) %}{% if currentItem.answer.exists() %}7. Feeling afraid as if something awful might happen {% for answer in currentItem.answer %}"{% if answer.value.code = 'Not at all' %}Not at all{% endif %}{% if answer.value.code = 'Several days' %}Several days{% endif %}{% if answer.value.code = 'Over half the days' %}Over half the days{% endif %}{% if answer.value.code = 'Nearly every day' %}Nearly every day{% 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 = 'item37281656' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item37281656' and answer.exists()) %}{% if currentItem.answer.exists() %}If you checked off any problems, how difficult have these made it for you to do your work, take care of things at home, or get along with other people? {% for answer in currentItem.answer %}"{% if answer.value.code = 'Not difficult at all' %}Not difficult at all{% endif %}{% if answer.value.code = 'Somewhat difficult' %}Somewhat difficult{% endif %}{% if answer.value.code = 'Very difficult' %}Very difficult{% endif %}{% if answer.value.code = 'Extremely difficult' %}Extremely difficult{% endif %}"{% endfor %}{% endif %}{% endfor %}
GAD-7 Score: {{answer}}$SEP${% 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 = 'section13142135').exists() %}{% for currentItem in currentItem.item.where(linkId = 'section13142135') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'includeCPP' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'includeCPP' and answer.exists(value.ofType(boolean)=true)) %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 's__section').exists() %}CPP {% for currentItem in currentItem.item.where(linkId = 's__section') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'i_ncurrent_problems_n').exists() %}Current Problems:
{% for currentItem in currentItem.item.where(linkId = 'i_ncurrent_problems_n') %}{% 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() %} {% 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 = 'i_npast_medical_histo').exists() %}Past Medical History:
{% for currentItem in currentItem.item.where(linkId = 'i_npast_medical_histo') %}{% capture childItems %}{% 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() %} {% 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 = 'i_nfamily_history_n').exists() %}Family History:
{% for currentItem in currentItem.item.where(linkId = 'i_nfamily_history_n') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'fhx' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'fhx' 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 = 'i_nmedications_n').exists() %}Medications:
{% for currentItem in currentItem.item.where(linkId = 'i_nmedications_n') %}{% capture childItems %}{% 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() %} {% 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 = 'allergies').exists() %}Allergies:
{% for currentItem in currentItem.item.where(linkId = 'allergies') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'allg' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'allg' 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 = 'i_ntreatments_n').exists() %}Treatments
{% for currentItem in currentItem.item.where(linkId = 'i_ntreatments_n') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'tx' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'tx' 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 = 'i_nsocial_history_n').exists() %}Social History:
{% for currentItem in currentItem.item.where(linkId = 'i_nsocial_history_n') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'soc' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'soc' 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 %}{% 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 = 'section41290342').exists() %}Thank you for completing this referral to the Ontario Structured Psychotherapy (OSP) program.
{% for currentItem in currentItem.item.where(linkId = 'section41290342') %}{% capture childItems %}{% 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 = 'section98670638').exists() %}{% for currentItem in currentItem.item.where(linkId = 'section98670638') %}{% capture childItems %}{% 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 %}