admin-dynoform.cp.prism-ubc.linaralabs.com Open in urlscan Pro
137.82.155.94  Public Scan

Form analysis
0 forms found in the DOM

Text Content

You need to enable JavaScript to run this app.

Test URL


ACCEPT MODEL

Gender
female


Age (year) 



Is the patient currently a smoker?
no


Has the patient received oxygen therapy within the last year?
yes


Is the patient currently on statins?
yes


Is the patient currently on LAMAs?
yes


Is the patient currently on LABAs?
yes


Is the patient currently on inhaled corticosteroids?
no


Post-bronchodilator FEV1 (% predicted) 



Body mass index (BMI) 



St. Georges Respiratory Questionnaire Score (SGRQ)



Number of All Exacerbations within the last 12 months



Number of Severe Exacerbations within the last 12 months



Submit