,

Blood Dyscrasia AESI Form 11-0019-F-V-1

$120.00

The Blood Dyscrasia AESI Form includes 3 pages of detailed questions to healthcare professionals to assess case causality.

Document Description

The Blood Dyscrasia AESI Form asks the relevant questions over three pages for a medical assessment and potential relationship determination for the medicinal product – including:

  • Patient information
  • Medication
  • Signs and symptoms
  • Laboratory measures
  • Relevant findings
  • Patient history
  • Risk factors

The form comes ready to use and adapt to your company.