Pandemic Case Study

Instructions:

This case report is for ONE treatment only.  If you changed the formula in subsequent treatments, please fill out the form for each treatment explaining how the S&S, etc. changed. When  you add more than one treatment for the same patient, you must use the EXACT same patient description each time.  You will receive an email copy of the first treatment if you should forget the wording of your patient description. All fields with asterisks must be filled out or the form will not allow you to submit.

Please add comments to Other field where possible and to General comments at end if there’s no “other” field where you think a parameter should change.

If you have any technical issues filling out the form or submitting the form,
we kindly request you feedback in a separate form so we can fix it.

Fill out below form only if you have technical issues with the form or submitting the form