Pulmonology Admission Form Template

This admission form supports the evaluation of respiratory cases such as asthma, COPD, pneumonia, tuberculosis, or other breathing-related conditions. It includes detailed respiratory history, chest exam findings, and investigation checklists.

Key Features

  • Respiratory symptom checklist

  • Chest examination findings

  • Risk factor assessment

  • Pulmonary investigations (CXR, PFT, ABG, sputum)

  • Initial treatment plan

Who Should Use It

Pulmonology departments, TB clinics, emergency units, and general physicians.

Why It Helps

Ensures complete, systematic assessment of respiratory patients.

pulmonology admission form template for respiratory illness documentation
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