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Side effects reporting
Please use this form to report side effects from LOWTREX LDN only.
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* Indicates required question
Please enter your first and surname INITIALS (data is anonymous)
*
Your answer
Enter your email for confirmation copy
Your answer
How long have you been taking LDN
*
Just recently (within a week)
Within the last 28 days
Within 3 months
Long term
What dose did you start seeing this side effect
*
<1mg
1mg - 2mg
2mg-3mg
3mg-4.5mg
>4.5mg
Describe the side effect
*
Your answer
Did you do anything to improve this side effect?
*
Your answer
Who have you told about this side effect?
*
My prescriber or clinic
My Pharmacy
The LDN Research Trust
Other:
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