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Symptom and timing panel
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Days since symptom started:Find:Pt:^Patient:Ord:
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Days since symptom finished:Find:Pt:^Patient:Ord:
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I have been short of breath in the past 7D:Find:7D:^Patient:Ord:
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Sought medical attention for symptoms:Find:RptPeriod:^Patient:Nom:
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Type of medical attention accessed:Type:RptPeriod:^Patient:Nom:
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Temperature taken RptPeriod
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Clinical measurement by
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Body temp.max RptPeriod
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deg
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Close contact with COVID-19 in last 2W:Find:2W:^Patient:Nom:
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Has or had COVID-19:Hx:Pt:^Patient:Ord:
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Date of first infection onset:Date:Pt:^Patient:Nom:
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{mm/dd/yyyy}
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Comorbidities and coexisting conditions:Find:Pt:^Patient:Nom:
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Condition
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Informed of being at severe risk from COVID-19 due to an underlying health condition:Find:Pt:^Patient:Ord:
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Has health problems that require activity limits:Find:Pt:^Patient:Ord:
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Require help from others:Find:Pt:^Patient:Ord:
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Health prob require stay home
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Is someone available to help you if you need it:Find:Pt:^Patient:Ord:
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Mobility device reg used
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Takes routine med
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Flu vacc last 12Mo
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Symptom
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Date+time symptom onset
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