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Pt. Tolerated Tx Well? (*DC Only)
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Additional Information
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Primary Complaint
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Better?
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If so, how are they better?
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Same?
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If so, how are they the same?
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Worse?
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If so, how are they worse?
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Additional Information
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Secondary Complaint
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Better?
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If so, how are they better?
• • •
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Same?
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If so, how are they the same?
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Worse?
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If so, how are they worse?
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Additional Information
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Other Complaint
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Better?
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If so, how are they better?
• • •
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Same?
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If so, how are they the same?
• • •
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Worse?
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If so, how are they worse?
• • •
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Additional Information
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