|
Symptoms/ Side Effects
• • •
|
Were labs drawn?
|
|
Any new changes?
|
Lot Numbers ( IM Injections)
• • •
|
|
Testosterone Dose
|
IM inj.
• • •
|
|
Estrogen Blocker/ Metabolizer
• • •
|
Weight Loss Injection
|
|
Injection Site
• • •
|
Therapeutic Phlebotomy
|
|
Name of clinician seen
• • •
|
Hgb Finger stick check
|
