GYNECOLOGY (PAP SMEAR) (1695)    AP DIALOG CONFIG (101.45)

Name Value
NAME GYNECOLOGY (PAP SMEAR)
ORDERABLE ITEM GYNECOLOGY (PAP SMEAR)
NATIONAL STANDARD 1
ORDER PROMPTS
  • ORDER PROMPT:   URGENCY
    REQUIRED:   TRUE
  • ORDER PROMPT:   COLLECTION DATE/TIME
    REQUIRED:   TRUE
  • ORDER PROMPT:   COLLECTION TYPE
    HIDE:   TRUE
    DEFAULT:   WC
  • ORDER PROMPT:   HOW OFTEN
    HIDE:   TRUE
  • ORDER PROMPT:   SURGEON/PROVIDER
    REQUIRED:   TRUE
PAGES
  • PAGE#:   1
    PAGE NAME:   Clinical History
    REQUIRED:   TRUE
    RESPONSE ID:   CLINHX
    WP TITLE:   Additional Clinical History
    BUILDER BLOCK:
    • PG BLOCK TITLE:   Visit Type
      VALUES:
      • VALUE:   Screening
      • VALUE:   Medically Indicated/Diagnostic
    • PG BLOCK TITLE:   Menstrual Status
      REQUIRED:   TRUE
      VALUES:
      • VALUE:   Last Menstrual Period
        ASSOCIATE WITH:   DATE
        DATE RESTRICTION:   PAST DATE ONLY
      • VALUE:   Postmenopausal
        SPECIAL:   3
      • VALUE:   Unknown
    • PG BLOCK TITLE:   Hormone Therapy
      VALUES:
      • VALUE:   No Hormone Therapy
      • VALUE:   Hormone Replacement Therapy
      • VALUE:   Vaginal Cream (Hormonal)
    • PG BLOCK TITLE:   Applicable History
      LIST:   TRUE
      VALUES:
      • VALUE:   Hysterectomy
      • VALUE:   Prior Abnormal PAP Smear
      • VALUE:   Hormones/Birth Control
      • VALUE:   Radiation/Chemotherapy
      • VALUE:   Abnormal Bleeding
      • VALUE:   IUD
      • VALUE:   Post Partum
      • VALUE:   Pregnant
      • VALUE:   Not Menstruating
SPECIMEN
  • BUILDER BLOCK:
    • SP BLOCK TITLE:   Specimen Type
      DEFAULT:   Thin Prep/Liquid based
      VALUES:
      • Thin Prep/Liquid based
    COLLECTION SAMPLE HIDE:   TRUE
    COLLECTION SAMPLE DEFAULT:   AP SPECIMEN
  • BUILDER BLOCK:
    • SP BLOCK TITLE:   Specimen Type
      DEFAULT:   Thin Prep/Liquid based
      VALUES:
      • Thin Prep/Liquid based
    COLLECTION SAMPLE HIDE:   TRUE
    COLLECTION SAMPLE DEFAULT:   AP SPECIMEN