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STAT PHARMACY ORDER (Place X in Box) CHEMOTHERAPY AND THERAPY ORDER SHEET CODEX (Cycle 1 and 3) CODEX / IVAN Regimen PATIENT INFORMATION A. Diagnosis: Burkitt s Lymphoma (high risk patients) B. Allergies:
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Start by gathering all the necessary information and materials needed for cycles 1 and 3. This could include any forms, documents, or resources that are specific to these cycles. Ensure that you have everything readily available before beginning the filling out process.
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