I have had the opportunity to discuss the riskd, benefits, and potential side effect of the listed medications with my doctor, and have received a reasonable explanation.
I understand that medications of this type have been successfull in treatment of similar symtoms in others. Further, I understand that there is no guarantee that these agents will be as effective with my particular symptoms. I agree to notify my physician in the even that I experience any side effects or problems with the above medications.