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Evaluation

Are you evaluating a pediatric patient being discharged from the hospital after an admission for pneumonia?

Birthdate (enter MM/DD/YY)

Date of hospital admission (MM/DD/YY)

Number of chronic comorbid conditions (not including asthma)

Does the child have asthma?

Number of previous admissions to a hospital in the past year (not including this one)

Length of current hospital stay

days

Was the pneumonia during this admission complicated?

Results

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