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Dry Eye Assessment and Management Study FOLLOWUP DIETARY SUPPLEMENT FORM FS (029.1× 04×23/2014-Page 1 of 1 ID. No.: Alpha Code: Visit: Instructions: Information must be obtained during the followup
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How to fill out follow-up dietary supplement form:

01
Start by carefully reading the instructions provided on the form. Understanding the requirements and any specific guidelines will help you fill it out accurately.
02
Fill in your personal information accurately. This may include your full name, contact information, date of birth, and any other relevant details required by the form.
03
Provide details about the specific dietary supplement you are using or have used in the past. This may include the brand name, dosage, duration of use, and any known side effects or benefits experienced.
04
Answer any questions related to your current health condition. The form might inquire about existing medical conditions, medications being taken, or any allergies you may have, as this information can help with evaluating the safety and efficacy of the dietary supplement.
05
If the form requires you to provide specific dates or timeframes, make sure to accurately fill them in. This could be related to the duration of supplement use or any relevant medical events, such as surgeries or treatments.
06
Review your answers before submitting the form. Double-check for any errors or missing information that could potentially affect the evaluation process.
07
Sign and date the form as required. This indicates that you have provided truthful and accurate information.
Remember, it is always a good idea to consult with a healthcare professional before starting any dietary supplement. They can provide guidance and ensure the supplement is suitable for your specific needs.

Who needs follow-up dietary supplement form?

01
Individuals who have previously filled out a dietary supplement form and need to provide updates, such as changes in their health condition or medication usage.
02
People who have been advised by their healthcare provider to track their dietary supplement use and its effect on their health.
03
Anyone participating in a research study or clinical trial involving dietary supplements, as frequent monitoring and follow-up are often required in such cases.

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