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New Patient Assessment

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  2. Rick Simpson Oil Cancer Study
  3. New Patient Assessment
New Patient AssessmentMyMJStory2020-01-06T03:40:04-07:00
1Patient Info
2Medication Info
3Side Effects
  • Have new blood work? Click Yes to enter the results
  • Blood Work

  • ANCHematocritHemoglobin
  • PlateletsRed CellsWhite Cells
  • blood-cell-chart
  • Be sure to include all of your dosages
    TimeAmount TakenHow Taken 
  • Record your chemotherapy treatments here
    TimeTypeAmount Taken 
  • Other Medication

  • Be sure to list everything you tak including things like vitamins, herbs and other supplements. Be sure to include "as needed" items like aspirin and allergy medication.
    TimeDrug or SupplementAmount Taken 
  • Side Effects

    You may have none, some, or all of these, or you may have side effects not listed here.
  • Record your highest temperature for the day.
  • Other Side Effects

  • This field is for validation purposes and should be left unchanged.

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