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INJECTION NUMBER
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|
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CURRENT PAIN
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PAIN LAST WEEK
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COMPLICATIONS from previous Injection?
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Prev inj Complications comments
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PATIENT POSITION
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AREA
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LOCATION OF INJECTION
• • •
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MEDICATION INJECTED
• • •
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COMPLICATIONS?
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What COMPLICATIONS?
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FOLLOW-UP
• • •
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Follow up comments
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