Thyroid Cancer Aide
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First Name:
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Birthdate:
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Health Card Number:
Cancer Type:
Select Cancer Type
Papillary
Follicular
Medullary
Anaplastic
Cancer Stage:
Select Cancer Stage
Stage I
Stage II
Stage III
Stage IV
Target TSH Range:
Select TSH Range
A: 0.01-0.1 mIU/L
B: 0.1-0.5 mIU/L
C: 0.35-2.0 mIU/L
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Thyroid Cancer Aide
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Date:
TSH (mIU/L):
Thyroglobulin (µg/L)[Optional]:
Synthroid*(µg):
100 microgram = .0001 gram
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TSH vs Date
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