Include:
How many units of alcohol weekly
How may cigarettes daily
Include:
Dates (From -To)
Treatment/s received or receiving (non-surgical)
Previous Surgery (Dates and surgery)
Pain Score (1-10)
Include: Frequency (weekly, monthly) Length of time they last (hour, minutes) Date of last headache/migraine
Include:
Name of disorder
Dates (From -To)
Treatment/s received or receiving (non-surgical)
Previous Surgery (Dates and surgery)
Include:
Date (year)
Which Eye was affected (L or R)
Type of trauma/disease
Treatment/s received
Include:
Which Joint in your body
Date of onset (Year)
Treatment/s received
Include:
Year of onset (perimenopause/menopause)
Cycle days
Any further information you wish to disclose
Include:
Drug name
Dosage
Frequency (Daily, 2 x day, 3 x day, 4 x day)
Length of time you have taken (days, weeks, months, years)
Include:
Brand
Dosage
Frequency (Daily, 2 x day etc)
Length of time you have taken (days, weeks, months, years)
Include:
Frequency (days)
Length (time)
Rest (days)
Include:
Name of app
Daily Carb, Protein and Fat intake
