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Adverse Event Form

Adverse Event (AE): any untoward medical occurrence that may present during treatment with a medicine but which does not necessarily have a causal relationship with this treatment.

Adverse Drug Reaction (ADR): a response to a medicine which is noxious & unintended, including lack of efficacy and which occurs at any dosage & can also result from overdose, misuse or abuse of a medicine.

Patient Information

Adverse Reaction

Must be between 1 and 1000 words. Total word count: 0


Adverse Reaction Outcome