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  • Or Reported Case Intake Form: Vaping - Associated Lung Injury 2019

Get Or Reported Case Intake Form: Vaping - Associated Lung Injury 2019-2025

And Demographics Patient Name Age in years Patient DOB Parent/Guardian Name (if under 18) Patient/parent phone number Patient Street Address Line 1 Patient Street Address Line 2 City County State OR Zip Code Sex Race Ethnicity Patient Exposure Information Has patient ever vaped? (any product) Yes No Unk Did the patient vape in the last 90 days? Yes No Unk How often does the patient report vaping? Did the patient vape a nicotine containing product? Yes No Unk Did the patient v.

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Breathing in the harmful chemicals from vaping products can cause irreversible (cannot be cured) lung damage, lung disease and, in some cases, death. Some chemicals in vaping products can also cause cardiovascular disease and biological changes that are associated with cancer development.

What are the symptoms of EVALI? Shortness of breath. Cough. Chest pain. Fever and chills. Diarrhea, nausea, vomiting, and abdominal pain. Rapid heartbeat. Rapid and shallow breathing.

Diacetyl is frequently added to flavored e-liquid to enhance the taste. Inhaling diacetyl causes inflammation and may lead to permanent scarring in the smallest branches of the airways — popcorn lung — which makes breathing difficult.

EVALI may cause the following symptoms: Shortness of breath. Cough. Chest pain. Fever and chills. Diarrhea, nausea, vomiting, and abdominal pain. Rapid heartbeat. Rapid and shallow breathing.

The Benefits of Quitting Additionally, quitting vaping will improve your blood circulation and enable your lungs to begin healing. This will result in fewer coughing episodes and improved breathing ability during physical activity.

Breathing in the harmful chemicals from vaping products can cause irreversible (cannot be cured) lung damage, lung disease and, in some cases, death.

ing to the CDC criteria, EVALI is a clinical diagnosis that requires the use of an e-cigarette in the 90 days preceding the appearance of initial symptoms; pulmonary infiltrates on a plain chest radiograph or chest CT, and the absence of any other possible etiology, such as infection.

However, it typically takes years, even decades for those conditions to develop. But with vaping, we're seeing lung damage developing in much less time; often under a year.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232