ProACT | Emergency Medicine

Visit UAB Apply to UAB Request Info

Advising Undergraduate Catalog Request Info Research and Service Learning

Graduate School Graduate Catalog Online Degrees

Services Resources Family Visits

Get Involved Benefits Events

Office of Provost Human Resources Faculty Resources Staff Council

Office of Research Harbert Institute CCTS

UAB Medicine UAB Dentistry UAB Optometry

Colleges & Schools

Department of Emergency Medicine Heersink School of Medicine

Your Name

Invalid Input

Date

Invalid Input

Pod

Bed Number

Patient Age

Invalid Input

Gender

Male

Female

Invalid Input

Patient ED arrival time

Invalid Input

All of the following must be YES

Alert and Oriented

Yes

Invalid Input

Age Greater than 18 years old

Yes

Invalid Input

Primary Impression of Lower Respiratory Infection

Yes

Invalid Input

All of the following must be NO

Cancer or taking chemo

Invalid Input

Surgery within last 7 days

Invalid Input

Currently on antibiotics

Invalid Input

Additional Comments

Invalid Input

(*)

Invalid Input