|
L, R or Bilateral? _1
|
Which side first? _2
|
|
Skin cleanser? _3
|
Needle Size _4
|
|
Combination injectate volume? _5
|
Anesthesia concentration? _6
|
|
Anesthesia type? _7
|
Steroid concentration _8
|
|
Steroid name? _9
|
Optional Bilateral _10
|
|
Impression - add period to make visible
|
|
