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woundcare test
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Practice Details
Practice Name*
Practice Name is required
Practice Postcode*
Practice Postcode is required
Invalid Practice Postcode
Main contact name for case*
Contact is required
Email*
Email is required
Invalid Email
Telephone*
Telephone is required
Patient Details
Patient Name*
Patient Name is required
Patient Details - Species, breed & age*
Patient Details is required
Is the patient hospitalised?*
Yes
No
Hospitalised is required
Is the patient's movement being restricted?*
Yes
No
Movement Restricted is required
Does the patient have any underlying health conditions?*
Yes
No
Health Conditions is required
Wound Details
Area of injury/wound*
Injury Area is required
Approximate wound size*
Wound Size is required
Initial injury date*
Injury Date is required
Origin of wound*
Wound Origin is required
Exudate Level*
None
Low
Medium
High
Exudate Level is required
Is the wound dry or is there any exudate coming from it? If exudate is present, is it clear?*
Wound Exudate is required
Current photo of wound*
Add Files
Wound Photo is required
Invalid Wound Photo
Notes
Any other notes or details?
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