Step Form with Radio Buttons & Progress Bar

Is the patient showing any of these symptoms?

choose one or more Symptoms.

Chest Pain or Tightness

Chills or Sweating

Fatigue

Night Sweats

Swelling in Ankles, Feet or Legs

Loss of Taste or Smell

Weakness

Fever

Headache

Weight Loss

Loss of Appetite

Body Aches

Rhinorrhea

Pain While Breathing or Coughing

Heartburn

Runny or Stuffy Nose

Shortness of Breath

Exposure to Air Pollution/Dust/Toxic Gases

Sneezing

Swollen Fingertips with Curved Nails (Nail Clubbing)

Throat Discomfort

Watery or Itchy Eyes

Skin Rashes

Wheezing

What seems to make the patient’s symptoms worse?

Certain triggers can make the cough worse. Do any of these apply to him/her?

Pollution

Allergens None of the above

What type of cough IS THE patient experiencing?

This will help us narrow down the possible causes.

Dry Cough

Wet Cough

Let's take a closer look at the mucus.

The type of mucus can tell us a lot about what’s going on.

Mucoid

(Clear or white and frothy)

Mucopurulent

(Slightly thicker and cloudy or opaque)

How long has the cough been bothering the patient?

Pinning down the duration helps us understand the symptoms better.

Acute (< 3 weeks) Subacute (3-8 weeks) Chronic (> 8 weeks)