<% if (typeof profile !== "undefined") { %>
Name
<%= profile.nameFirst %> <%= profile.nameLast %>
<% if (profile.lmp) { %>
Last Menstrual Period (mm/dd/yyyy)
<%= formatDate(new Date(profile.lmp)) %>
<% } %>
<% if (profile.edd) { %>
Estimated Due Date (mm/dd/yyyy)
<%= formatDate(new Date(profile.edd)) %>
<% } %>
<%
var pregnancyText = 'Pregnancies (including this one)';
if (profile.noOfPregs === '1') {
pregnancyText = 'Pregnancy';
}
%>
<%= profile.noOfPregs %> <%= pregnancyText %>
<%
var deliveryText = 'Deliveries';
if (profile.noOfDeliveries === '1') {
deliveryText = 'Delivery';
}
%>
<%= profile.noOfDeliveries %> <%= deliveryText %>
<% if (profile.wbp !== "") { %>
Weight Before Pregnancy (pounds)
<%= profile.wbp %>
<% } %>
<% if (profile.currWgt !== "") { %>
Current Weight (pounds)
<%= profile.currWgt %>
<% } %>
<% if (profile.obProvider !== "") { %>
OB Provider
<%= profile.obProvider %>
<% } %>
<% _.each(profile.obContacts, function (contact) {
if (contact.contactInfo !== "") { %>
OB Contact Info (<%= contact.contactType.toString() %>)
<%= contact.contactInfo.toString() %>
<% } }) %>
<% if (profile.mcc !== "") { %>
Maternity Care Coordinator (MCC)
<%= profile.mcc %>
<% } %>
<% if (profile.mccContact !== "") { %>
MCC Phone Number
<%= profile.mccContact %>
<% } %>
<% } %>
<% if (typeof diagnosisList !== "undefined") { %>
<% _.each(diagnosisList, function (diagnosis, i) {
if (i > 0) {
%>
<% } %>
Condition
<%= diagnosis.diagnosisName %>
<% if (diagnosis.comments !== "") { %>
Comments
<%= diagnosis.comments %>
<% }
if (diagnosis.onsetDate) { %>
Date Condition Began (mm/dd/yyyy)
<%= formatDate(new Date(diagnosis.onsetDate)) %>
<% } %>
Status
<% if(diagnosis.status) { %>
Past <% } else { %>
Current
<% } %>
<% }) %>
<% } %>
<% if (typeof medicationsList !== "undefined") { %>
<% _.each(medicationsList, function (medication, i) {
if (i > 0) { %>
<% } %>
Medication Name
<%= medication.medicationName %>
Type of Medication
<%= medication.medicationType %>
Currently Taking
<% if(medication.currentlyTaking) { %>
Yes
<% } else { %>
No <% } %>
<% if(medication.strength !== "") { %>
Strength
<%= medication.strength %>
<% } %>
<% if(medication.frequencyTaken !== "") { %>
Frequency Taken
<%= medication.frequencyTaken %>
<% } %>
<% if(medication.instructions) { %>
Instructions
<%= medication.instructions %>
<% } %>
<% if(medication.reasonForTaking !== "") { %>
Reason For Taking
<%= medication.reasonForTaking %>
<% } %>
<% if(medication.refillsRemaining !== "") { %>
Refills Remaining
<%= medication.refillsRemaining %>
<% } %>
<% if(medication.rxNumber !== "") { %>
Rx Number
<%= medication.rxNumber %>
<% } %>
<% if(medication.prescriber !== "") { %>
Prescriber
<%= medication.prescriber %>
<% } %>
<% if(medication.pharmacyName !== "") { %>
Pharmacy Name
<%= medication.pharmacyName %>
<% } %>
<% if(medication.pharmacyPhoneNumber !== "") { %>
Pharmacy Phone Number
<%= medication.pharmacyPhoneNumber %>
<% } %>
<% if (medication.lastRefillDate) { %>
Last Refill Date (mm/dd/yyyy)
<%= formatDate(new Date(medication.lastRefillDate)) %>
<% } %>
<% if (medication.startDate) { %>
Start Date (mm/dd/yyyy)
<%= formatDate(new Date(medication.startDate)) %>
<% } %>
<% if (medication.stopDate) { %>
Stop Date (mm/dd/yyyy)
<%= formatDate(new Date(medication.stopDate)) %>
<% } %>
Side Effects
<% if(medication.unwantedSideEffects) { %>
Yes <% } else { %>
No
<% } %>
<% if(medication.sideEffectsComment !== "") { %>
Describe Side Effects
<%= medication.sideEffectsComment %>
<% } %>
<% if(medication.comments !== "") { %>
Comments
<%= medication.comments %>
<% } %>
<% }); %>
<% } %>
<% if (typeof allergiesList !== "undefined") { %>
<% _.each(allergiesList, function (allergies,i) {
if (i > 0) { %>
<% } %>
Allergy
<%= allergies.allergy %>
<% if(allergies.firstOccurred) { %>
Allergy First Occurred (mm/dd/yyyy)
<%= formatDate(new Date(allergies.firstOccurred)) %>
<% } %>
<% if(allergies.rash) { %>
<% } %>
<% if(allergies.hives) { %>
<% } %>
<% if(allergies.breathingProblems) { %>
<% } %>
<% if(allergies.vomiting) { %>
<% } %>
<% if(allergies.swelling) { %>
<% } %>
<% if(allergies.other) { %>
<% } %>
<% if(allergies.otherReactions !== "") { %>
Describe Other Reaction
<%= allergies.otherReactions %>
<% } %>
<% if(allergies.severity !== "") { %>
Severity
<%= allergies.severity %>
<% } %>
<% if(allergies.description !== "") { %>
Describe Treatment
<%= allergies.description %>
<% } %>
Has a physician confirmed this allergy?
<% if(allergies.diagnosed) { %>
Yes <% } else { %>
No <% } %>
<% if(allergies.provider !== "") { %>
Provider Who Diagnosed Allergy
<%= allergies.provider %>
<% } %>
<% if(allergies.facility !== "") { %>
Facility Where Diagnosed
<%= allergies.facility %>
<% } %>
<% if(allergies.comments !== "") { %>
Comments
<%= allergies.comments %>
<% } %>
<% }) %>
<% } %>
<% if (typeof labs !== "undefined") { %>
<% if (labs.bloodType !== "") { %>
Blood Type
<%= labs.bloodType %>
<% } %>
<% if (labs.rhType !== "") { %>
Rh Type
<%= labs.rhType %>
<% } %>
<% if (labs.antibodyScreen !== "") { %>
Antibody Screen
<%= labs.antibodyScreen %>
<% } %>
<% if (labs.papSmear !== "") { %>
Pap Smear
<%= labs.papSmear %>
<% } %>
<% if (labs.papSmearComment !== "") { %>
Pap Smear Comment
<%= labs.papSmearComment %>
<% } %>
<% if (labs.rubella !== "") { %>
Rubella (German Measles)
<%= labs.rubella %>
<% } %>
<% if (labs.varicella !== "") { %>
Varicella (Chicken Pox)
<%= labs.varicella %>
<% } %>
<% if (labs.hepatitisB !== "") { %>
Hepatitis B Surface Ag
<%= labs.hepatitisB %>
<% } %>
<% if (labs.gonorrhea !== "") { %>
Gonorrhea
<%= labs.gonorrhea %>
<% } %>
<% if (labs.chlamydia !== "") { %>
Chlamydia
<%= labs.chlamydia %>
<% } %>
<% if (labs.urineCulture !== "") { %>
Urine Culture
<%= labs.urineCulture %>
<% } %>
<% if (labs.rpr !== "") { %>
RPR (Syphilis)
<%= labs.rpr %>
<% } %>
<% if (labs.glucoseTolerance !== "" || labs.gttStatus !== "" || labs.glucoseLevel !== "") { %>
<% if (labs.glucoseTolerance !== "") { %>
Glucose Tolerance
<%= labs.glucoseTolerance %>
<% } %>
<% if (labs.gttStatus !== "") { %>
Result
<%= labs.gttStatus %>
<% } %>
<% if (labs.glucoseLevel !== "") { %>
Glucose Level
<%= labs.glucoseLevel %>
<% } %>
<% } %>
<% if (labs.groupBStrep !== "" ) { %>
Group B Strep
<%= labs.groupBStrep %>
<% } %>
<% _.each(labs.labTests, function (test, i) {
if (i > 0) { %>
<% } %>
<% if (test.testName !== "") { %>
Name of Test
<%= test.testName %>
<% } %>
<% if (typeof test.testDate !== "undefined") { %>
Date of Test (mm/dd/yyyy)
<%= formatDate(new Date(test.testDate)) %>
<% } %>
<% if (test.results !== "") { %>
Results for Test
<%= test.results %>
<% } %>
<%}) %>
<% } %>
<% if (typeof ultrasoundList !== "undefined") { %>
<% _.each(ultrasoundList, function(ultraSound, i) { %>
Date of Ultrasound
<%= formatDate(new Date(ultraSound.ultrasoundDate)) %>
<% _.each(ultraSound.fetuses, function (fetus, i) {
if (fetus.efw.weight !== "" || fetus.ega.weeks !== "" || fetus.ega.days !== "" ||
typeof fetus.ultrasoundEDD !== "undefined" || fetus.comments !== "") {
if (i > 0) {
%>
<% } %>
<% if (fetus.efw.weight !== "") { %>
Estimated Fetal Weight
<%= fetus.efw.weight %> <% if (fetus.efw.metric) { %> lbs <% } else { %> kg <% } %>
<% } %>
<% if(fetus.ega.weeks !== "" || fetus.ega.days !== "") { %>
Estimated Gestational Age
<% } %>
<%
var weekTxt = 'weeks'
var dayTxt = 'days';
if(fetus.ega.weeks !== "") { %>
<% if (fetus.ega.weeks <= 1) {
var weekTxt = 'week';
} %>
<%= fetus.ega.weeks %> <%= weekTxt %> <% }
if(fetus.ega.days !== "") { %>
<% if (fetus.ega.days <= 1) {
var dayTxt = 'day';
} %>
<%= fetus.ega.days %> <%= dayTxt %><% }
%>
<% if (typeof fetus.ultrasoundEDD !== "undefined") { %>
Estimated Due Date by Ultrasound
<%= formatDate(new Date(fetus.ultrasoundEDD)) %>
<% } %>
<% if (fetus.comments !== "") { %>
Comments
<%= fetus.comments %>
<% } %>
<% } }) %>
<% }) %>
<% } %>
<% if (typeof geneticScreeningList !== "undefined") { %>
<% _.each(geneticScreeningList, function (geneticscreening, i) {
if (i > 0) { %>
<% } %>
<% if(geneticscreening.testDate) { %>
Date of Test (mm/dd/yyyy)
<%= formatDate(new Date(geneticscreening.testDate)) %>
<% } %>
<% if(geneticscreening.counseling) { %>
<% } %>
<% if(geneticscreening.quad) { %>
MSAFP/AFP4/Quad screen
Yes
<% } %>
<% if(geneticscreening.amnio) { %>
<% } %>
<% if(geneticscreening.sickleCell) { %>
Sickle Cell Disease and Sickle Cell Trait
Yes
<% } %>
<% if(geneticscreening.canavan) { %>
<% } %>
<% if(geneticscreening.cystic) { %>
<% } %>
<% if(geneticscreening.cvs) { %>
Chorionic Villus Sampling (CVS)
Yes
<% } %>
<% if(geneticscreening.taySach) { %>
<% } %>
<% if(geneticscreening.thalassemia) { %>
<% } %>
<% if(geneticscreening.other) { %>
<% } %>
<% if(geneticscreening.otherTestName !== "") { %>
Other Test Name
<%= geneticscreening.otherTestName %>
<% } %>
<% if(geneticscreening.testResult !== "") { %>
Result of Test
<%= geneticscreening.testResult %>
<% } %>
<% if(geneticscreening.testNotes !== "") { %>
Notes
<%= geneticscreening.testNotes %>
<% } %>
<% }) %>
<% } %>
<% if (typeof vaccinations !== "undefined") { %>
<% if(vaccinations.fluShotLastAdmin) { %>
Flu Shot Last Administered (mm/dd/yyyy)
<%= formatDate(new Date(vaccinations.fluShotLastAdmin)) %>
<% } %>
<% if(vaccinations.fluShotNextDue) { %>
Flu Shot Next Due (mm/dd/yyyy)
<%= formatDate(new Date(vaccinations.fluShotNextDue)) %>
<% } %>
<% if(vaccinations.tdapLastAdmin) { %>
Tdap Last Administered (mm/dd/yyyy)
<%= formatDate(new Date(vaccinations.tdapLastAdmin)) %>
<% } %>
<% } %>
<% if (typeof pregOutcome !== "undefined") { %>
<% _.each(pregOutcome.outcomeList, function (outcome, i) {
if (i > 0) {
%>
<% } %>
Pregnancy Outcome
<%= outcome.outcome %>
<% if(outcome.otherOutcome !== "") { %>
Comments For Other Outcome
<%= outcome.otherOutcome %>
<% } %>
<% if(outcome.endDate) { %>
End Date of Pregnancy
<%= formatDate(new Date(outcome.endDate)) %>
<% } %>
<% if(outcome.outcome === "C-Section" || outcome.outcome === "Vaginal Delivery") { %>
Infant's Sex
<% if(outcome.sex) { %> Male <% } else { %> Female <% } %>
<% } %>
<% if(outcome.weight !== "") { %>
Weight (lbs)
<%= outcome.weight %>
<% } %>
<% if(outcome.length !== "") { %>
Length (inches)
<%= outcome.length %>
<% } %>
<% if(outcome.firstName !== "") { %>
First Name
<%= outcome.firstName %>
<% } %>
<% if(outcome.lastName !== "") { %>
Last Name
<%= outcome.lastName %>
<% } %>
<% if(outcome.comments !== "") { %>
Comments About Pregnancy Outcome
<%= outcome.comments %>
<% } %>
<% }) %>
<% } %>