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Custom Event

Custom Event . Page 1 of 4. Heat Hypotension Hypothermia Lethargy Nausea Suprapubic tenderness. Custom Event . OMB No. 0920-0666 Exp. Date: xx-xx- xxxx. Page 2 of 4. (specify): _________________________. CDC 57.115 (back), Rev 2, v6.4. Custom Event . OMB No. 0920-0666

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Custom Event

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  1. Custom Event Page 1 of 4 • Heat • Hypotension • Hypothermia • Lethargy • Nausea • Suprapubic tenderness

  2. Custom Event OMB No. 0920-0666 Exp. Date: xx-xx-xxxx Page 2 of 4 (specify): _________________________ CDC 57.115 (back), Rev 2, v6.4

  3. Custom Event OMB No. 0920-0666 Exp. Date: xx-xx-xxxx Page 3 of 4 Result Codes S = Susceptible I = Intermediate R = Resistant NS = Non-susceptible S-DD = Susceptible-dose dependent N = Not tested § GENTHL and STREPHL results: S=Susceptible/Synergistic and R=Resistant/Not Synergistic CDC 57.115 (back), Rev 2, v6.4

  4. Custom Event OMB No. 0920-0666 Exp. Date: xx-xx-xxxx Page 3 of 4 CDC 57.115 (back), Rev 2, v6.4

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