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PACE  HEALTH  SYSTEMS  LTD

               

 
Why bother to register ?

You can get by without registering, but if you would like us to personalize your scripts, we need to know your preferences for anti-nausea medication and gastritis protection.  We promise not to pass on your details or your prescribing patterns to any outside agency without your permission.

Chemotherapy Scripts
Questions/Suggestions
     

 

 

                        REGISTRATION      FORM 

Your Surname :

First Name  :    

Title             :    

Institution     :     

Street          :     

District         :     

Town           :     

Country       :      

ZIP/Postcode                          

Telephone   :      

Email            :    

Enter your hospital preferences below

IV anti nausea medication: default = ondansetron

                     dose (mgs):          default =  8

                      Frequency:    default = od

Oral anti nausea meds: default = metoclopramide

                     dose (mgs):          default =  10

                      Frequency:      default = tid

Gastritis prophylaxis: default = ranitidine             (for steroid containing regimens)

                     dose (mgs):          default =  150

                      Frequency:      default = bd

If you do not wish us to pass on your email address to selected companies please tick the box :   

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