Current Vitals

1
Full Legal Name:* This field is required.
First Name
Last Name
2
Date of Birth
Date
Year
Month
Day
3
Who is your Respiratory Therapist?
Alexander Grichuhin, RRT-RCP
Alexander Grichuhin, RRT-RCP
Melanie Klein, RRT-RCP
Channon Harper, CRT-RCP
Milly Castillo, RCP
4
Enter your Blood Pressure (120/70):
5
BORG (How out of breath do you feel 10 being worst, 0 is least)
10
9
8
7
6
5
4
3
2
1
0
6
How many Liters of oxygen are you using today (If none just leave blank)?
7
Please rate your pain, 10 is the worst, 0 is the least.
10
9
8
7
6
5
4
3
2
1
0
8
Oxygen readings on your pulse oximeter (After 30 seconds):* This field is required.
9
Pulse Rate (Found on your pulse oximeter):* This field is required.
10
Can you participate in therapy today?* This field is required.
YES
NO (if NO, Please excuse yourself from class & let your assigned clinician know)
Should be Empty: