| 
               Testosterone 
  
  
  
  
 | 
          
            
               MA Administering 
  
  
  
  
 | 
          
          
| 
               Dose given today 
  
  
  
  
 | 
          
            
               Site administered 
  
  
  
  
 | 
          
          
| 
               Lot Number 
  
  
  
  
 | 
          
            
               Expiration Date 
  
  
  
  
 | 
          
          
| 
               Vitamin Injection 
  
  
  
  
 | 
          
            
               | 
          
          
| 
               Lipo-B/Skinny Shot 
  
  
  
  
 | 
          
            
               Site administered 
  
  
  
  
 | 
          
          
| 
               Lot Number 
  
  
  
  
 | 
          
            
               Expiration Date 
  
  
  
  
 | 
          
          
| 
               Tri-Amino 
  
  
  
  
 | 
          
            
               Site administered 
  
  
  
  
 | 
          
          
| 
               Lot Number 
  
  
  
  
 | 
          
            
               Expiration Date 
  
  
  
  
 | 
          
          
| 
               B12 
  
  
  
  
 | 
          
            
               Site administered 
  
  
  
  
 | 
          
          
| 
               Lot Number 
  
  
  
  
 | 
          
            
               Expiration Date 
  
  
  
  
 | 
          
          
| 
               Next Labs Due 
  
  
  
  
 | 
          
            
               Other Labs 
  
  
  
  
 | 
          
          
| 
               Date of Last medication update 
  
  
  
  
 | 
          
            
               Last day of period 
  
  
  
  
 | 
          
          
| 
               Date of Allergy Testing  
  
  
  
  
 | 
          
            
               Date of Last blood draw 
  
  
  
  
 | 
          
          
| 
               Date of ANS 
  
  
  
  
 | 
          
            
               Date of Inbody 
  
  
  
  
 | 
          
          
| 
               Medication Refills Needed 
  
  
  
  
 | 
          
            
               | 
          
          
