SHORT FORM OR LONG FORM (Switch 3)
Choose between the Short Form,and the Long Form report by using
the third switch. The Long Form includes a respiratory history
questionnaire which allows you to record the patient’s respiratory
history:
NAME :
DATE :
SHORT FORM
ID:
LONG FORM
NAME :
DATE :
ID:
AGE 36 HEIGHT: 66in
Reason for test
Cough?
Sputum?
Smoker? Pack-years?___________
Q u i t ? When?
Dyspnea?
When?
Chest Pain?
Heart Disease?
Wheeze/Asthma?
CutlS Surgery
Abn
.
Chest X - R a y ?
FLOW/VOLUME PLOT OR VOLUME/TIME PLOT (Switch 4)
Choose a Flow/Volume plot or a Volume/Time plot for FVC maneu-
vers using the fourth switch. See examples below:
FLOW/VOLUME
F’JC
.
: : : : : : : :
VOLUME/TIME
