COVID-19 Wound Photos

Purpose of this online submission form is to collect images of unusual/atypical wounds, skin tears and/or injuries that the WOC nurses are seeing as a result of COVID-19. We would like to compile this information in an effort to utilize such to produce a clinical document in the near future. Thank you in advance for your collaboration and contributions to this project.

Your name*

Your email address*

This information will be used in case we need to collect additional information

Date when this photo was taken*

Please provide title for this image*

If submitting multiple images, please use space below to identify each image

Please provide description for this image*

If submitting multiple images, please use space below to provide description for each image

How does this wound/skin tear/injury differ from what you typically observe?*

Was this wound/skin tear/injury avoidable or unavoidable?*

Avoidable

Unavoidable

Not sure

Please provide explanation to the previous question in the space below.*

Use below space to explain what was different about this wound/skin tear/injury. For example: location, type of damage, etc.

Please list patient's comorbidity condition(s) in the space below.*

I own the rights to this image to use and distribute as I feel necessary.*

Agree

Disagree

I grant permission to the WOCN Society to use this image in future works.*

Agree

Disagree

This image is HIPPA compliant*

Agree

Disagree

Attachment(s)*

Please use space provided below to attach the image(s) and permission form(s), if appropriate

Drag and drop files here or

Send me a copy of my responses

Privacy Notice|Report Abuse