Doctor s Phone _____________________ uc

Referring Doctor

Patient s Name _____________________ Doctor s Name _____________________ Doctor s Phone _____________________

Patient s Name Doctor s Name Doctor s Phone

Doctor currently treating the patient

Prescribing doctor Phone No

Tell your doctor

The certificate of the doctor treating him her

31 Contact your doctor immediately

Consult with your health care provider before you travel.

Organisation Home environment Caregiver Treating physician

If you are uncertain, contact your doctor or pharmacist or the doctor or pharmacist of the child you are caring for.

Contact your doctor or pharmacist if needed.

This can be discussed with your doctor.

This should be discussed with your doctor.

Medical laboratory assistant educationalist environmental consultant.

ed After proper training in injection technique, patients may self inject with Trudexa if their physician determines that it is appropriate and with medical follow up as necessary.

ris After proper training in injection technique, patients may self inject with Trudexa if their physician determines that it is appropriate and with medical follow up as necessary.

This can be discussed with your doctor.

This can be discussed with your doctor.

This can be discussed with your doctor.

This can be discussed with your doctor.

This can be discussed with your doctor.

This can be discussed with your doctor.

This can be discussed with your doctor.

This can be discussed with your doctor.

Follow them exactly and visit your diabetes clinic regularly.

The schedule for monitoring should be determined by the treating physician.

You should also tell your doctor if you are breast feeding.

You should not switch to another nebuliser without consulting your treating doctor.

Tell your doctor if you have a history of heart failure.

The treatment may be repeated if considered indicated by the treating physician.

Thus, please tell your doctor if you have or have had

Tell your doctor if you have or have had any serious illness.

Mention any past or present serious illness to your doctor.

The growth of treated children should be regularly monitored by the treating physician.

Tell your doctor or healthcare professional or the doctor or healthcare professional of the child you are caring for as soon as possible.

Phone No _______________________________

Do not use Noxafil during pregnancy unless you are told by your doctor.

This can be discussed with your doctor (see Do not take Rebetol ).

You should continue to take VIRAMUNE for as long as instructed by your doctor.

A dose re escalation is permitted at the discretion of the physician.

Do not take Noxafil if you are pregnant unless you are told to by your doctor.

Do not use Noxafil if you are pregnant unless you are told to by your doctor.

However, this should be considered only after advice has been taken from an animal health advisor.