Notebook entry
People and process
- Doctor or nurse: name and job title: __________ / __________
- Virginia licence current: __________ / __________
- How they checked my health (video, questionnaire, exam): __________ / __________
- Follow-up access: __________ / __________
- Records shared on request: __________ / __________
Notebook entry
Product and pharmacy
- Medicine approved, made to order, or neither: __________ / __________
- Pharmacy name in the state record: __________ / __________
- Virginia pharmacy record: __________ / __________
- On the FDA list, if a batch-making site made it: __________ / __________
- Storage and problem contact: __________ / __________
Notebook entry
Full cost
- First visit: __________ / __________
- Monthly fee: __________ / __________
- Tests: __________ / __________
- Medicine and delivery: __________ / __________
- Regular monthly cost after any discount ends: __________ / __________