Fibroid Assessment

Fibroid & Endometriosis Assessment

Fibroid Assessment

Imaging and symptom review are required to ensure safe and appropriate use of the Shrink Protocol.

Fibroid Assessment

Section 1: Confirmed Diagnosis

 

Section 2: Imaging Confirmation (Mandatory for Fibroids)

 

Section 3: Fibroid Details

 

Section 4: Safety Screen

 

Section 5: Required Acknowledgments