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Combination Antibiogram Access Form
Thank you for choosing the Combination Antibiogram. By completing this form and clicking on the CONFIRM button, you have read, understand, and agree to these terms and conditions.
Terms and Conditions
I agree to use the resource under the following conditions:
I can demonstrate or present the resource and data generated within my organization, but the actual resource or copies thereof shall not be distributed to anyone outside of my organization.
I can distribute the resource to others in my organization provided they agree to the terms and conditions herein, and I shall be responsible for ensuring adherence.
The Combination Antibiogram is an electronic software tool using Excel that is designed to analyze institutional antimicrobial susceptibility data. I recognize that no claims or assumptions are made regarding indicated uses, efficacy or safety of the antibiotics selected for analysis.
To receive access to the Combination Antibiogram, please complete the form below.
* required fields
A brief Survey is also included with the download. This will allow for improvements to the Combination Antibiogram. We appreciate if you could complete and return the Survey to firstname.lastname@example.org within 30 days following examination or use of the tool. The survey results will be kept confidential.>
Thank You for Registering
After registering, the Combination Antibiogram will download as a zip file containing an overview of the tool (Microsoft Word) and the Combination Antibiogram itself (Microsoft Excel). Instructions for using the tool along with examples are included in the Excel file.
A brief Survey is also included with the download. This will allow for improvements to the Combination Antibiogram. We appreciate if you could complete and return the Survey to email@example.com within 30 days following examination or use of the tool. The survey results will be kept confidential.