He encontrado que alguna farmacia puede tener existencias limitadas de ciertos medicamentos, mientras que otras pueden tener casi cualquier formato que se le ocurra y el habitual de dosis habitualidad apareció. En resumen, siempre se contiene el almacén de corroborar. Al mismo tiempo que el producto que más que gustaba ha resultado no estaba disponible en stock otro distinto por las Buenas costumbres también debe buscarse jefe no asн parezca. Por eso es importante disponer de un Plan B para actuar cuandod ello no ocurra. Ventaja de tomar un genérico en lugar de Asix Un genérico es más barato que el nombre de marca Uno de los mayores incentivos para someterse al Dónde comprar Lasix genérico en lugar de pagar la marca es que usted puede obtener un ahorrando importantes Lasix genérico. Por lo tanto, un Lasix genérico es en general mucho más barato que el homólogo de marca, así que una denominación genérica se hace posible para las personas que usan este medicamento con frecuencia. Un ejemplo: La compra de lurosemida en lugar de Lasix es una considerable ahorro para el presupuesto mensual de medicamentos.

Cascadesurologycenter.com

CASCADES UROLOGY CENTER
Note: This is a confidential record and will be kept in our office. Information contained here will not be released to anyone without your authorization to do so.
Last Name: _______________________________ First Name: ______________________ Middle Name: ________________ Age: ________ Date of Birth: _____/_____/_______ Marital Status: S M D W Referral: ______________________ ___________________________________________________________________________________________________________
HISTORY OF THE PRESENT ILLNESS
What is the main reason for your visit to our office (Describe your problem in detail)_______________________________________ ___________________________________________________________________________________________________________ Days _________ Weeks ________ Months _______ Other ________________ Minutes _______Hours ________ Constant ______ Other ________________ Is anything else occurring at the same time? Nausea _______ Bleeding ______ Fever _________ Other ________________ Have you had similar problem in the past? No _____ Yes _____ How long ago? _____ Any treatment? ________ PLEASE MARK/ CIRCLE ALL THAT APPLY
Office use: Sto( )-Blo( )-Dys( )-UTI( )-GU surg( )-AUASx( )-PSA( ) Past MEDICAL ILLNESSES that apply:
If NONE, please mark here ( )
# times: ___________ Symptoms: burning / frequency / pressure / blood in urine / antibiotic helped ( ) – Blood in the urine # times: ___________ ( ) gross blood (urine was red) Had previous prostate biopsy: ( )Benign ( )Malignant # times: ___________ Side: Right / Left ( ) Passed spontaneously ( ) – Any urologic malignancy: ________________________________________________________________________________ ( ) – Problems urinating ( ) Difficulty urinating ( ) couldn’t urinate and had catheter placed ( ) couldn’t hold and needed pads ( ) Stroke ( ) Cancer: ___________________ ( ) Diabetes ( ) Glaucoma ( ) Heart problems ( ) High blood pressure ( ) Have children How many: _______ # times pregnant: _____ # Vaginal deliveries: _____ # C-Sections: _____ Other: _______ Other medical problems: ____________________________________________________________________________________
___________________________________________________________________________________________________________ Please list ALL previous SURGERIES that apply:
If NONE, please mark here ( )
Type:__________________ Side: Right____/Left____ # times:________ Year(s)________ Type:_______________________ ( )Benign ( )Malignant: Radiation___ Type: vag X abd How many times? ____ Year(s):______ Type: vag X abd Year: ________ ( )Benign ( )Malignant: Radiation___/Chemo___ ( ) Scrotum/testicle surgery ___________________________ How many times: _____________ ( )Cervical ( )Lumbar ( ) – Any other urologic surgery:________________________________________________________________________________ ( ) – Any other surgeries: ____________________________________________________________________________________
Please CIRCLE if you TAKE any of the following MEDICATIONS
If NONE, please mark here ( )
Aspirin -Coumadin (warfarin) – Plavix - Motrin, Advil (ibuprofen) - Flomax - Uroxatral - Hytrin (terazosin) - Cardura (doxazosin) Minipress (prazosin) - Proscar (finasteride) - Avodart - Detrol – Ditropan (oxybutinin)- Oxytrol patch - Vesicare – Enablex – Levsin Please list ALL other medications you are taking: ________________________________________________________________
___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ Please CIRCLE if you are ALLERGIC to the following MEDICATIONS
If NONE, please mark here ( )
Codeine - Iodine topical – Iodine dye(x-ray contrast) – Latex - Lidocaine gel - Nitrofurantoin(Macrodatnin/Macrobid) - Penicillin – Sulfa(Bactrin) What other medications are you allergic to? ________________________________________________________
__________________________________________________________________________________________________________ Please CIRCLE all FAMILY illnesses (add relationship if positive)
If NONE, please mark here ( )
( ) Prostate Cancer ________________ ( ) Kidney stones ______________ ( ) Cancer ______________ ( ) Diabetes ___________ Other family illnesses: ________________________________________________________________________________________ Please MARK/CIRCLE what applies to your HABITS/PERSONNAL:
If NONE, please mark here ( )
How much: _____ packs/day for _____years; Quit ______ years/months ago Regular_____ Decaf_____ How much: ______ cups/day Other: _____________________________________________ REVIEW OF SYSTEMS : Do you now or have you had any problems related to the following systems ? Circle Yes or No
Allergies
Integumentary
Cardiovascular
Gastrointestinal
Musculoskeletal
Constitutional
Genitourinary
Neurological
Ear/Nose/Throat/Mouth
Psychiatric
Endocrine
Hematologic
Respiratory
Blood clotting probl. Y N Frequent cough Y N Swollen glands Y N Shortness of breath Y N

Source: http://www.cascadesurologycenter.com/medicalform.pdf