Dose the patient being treated have any of the following conditions?

• Less than 2 years old.

• Fever over 101.5 F.

• Symptoms have gotten worse or new symptoms have developed after trying an over the counter treatment.

• Asthma, COPD or other respiratory condition.

• Cardiovascular condition such as congestive heart failure.

• Chest pain.

• Shortness of breathe.

• Immunosuppression (weakened immune system) from medications or from a health condition.

• AIDS.

• Elderly and frail.

• Allergic or hypersensitive to OTC medications.

• Pregnancy.


Yes

No



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