Factor Log Sheet | Caremark Health Resources

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WEB SITE PRIVACY
POLICY

Factor Log Sheet

Ills & Conditions

Factor Log Sheet

Name: ________________________

Hemophilia type:

[ ] A (factor VIII)

[ ] B (factor IX)

Date

Time

Dose

Reason for infusion:

Factor lot number

Factor expiration date

Prevention

Treatment
Site of bleeding:

Reviewed by a member of the

First published February 1, 2000
Last updated December 2, 2002
Copyright © 2000 Accordant Health Services, Inc. All Rights Reserved.

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