Hospital Discharge instructions

You were admitted to the hospital for [text name="cc" default="cough and shortness of breath" size=64] and you were found to have [text name="primary_dx" default="COVID-19" size=64].

When you go home, you will need to make sure you:
[textarea name="instructions" default=""]

You will need to follow up with your primary care doctor in 1-2 weeks.

Return to the Emergency Department if you develop [text name="return_precautions" default="fever, chest pain, worsening shortness of breath, or fainting/loss of consciousness" size=64]

It was a pleasure taking care of you at Cayuga Medical Center.
You were admitted to the hospital for and you were found to have .

When you go home, you will need to make sure you:


You will need to follow up with your primary care doctor in 1-2 weeks.

Return to the Emergency Department if you develop

It was a pleasure taking care of you at Cayuga Medical Center.

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0, 4 form elements, 58 boilerplate words, 3 text boxes, 1 text areas, 4 total clicks
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