Get Chronic Gvhd Assessment And Scoring Form 1 Of 3 ...

Filling out the Chronic GVHD Assessment and Scoring Form is an essential task for evaluating the severity of chronic graft-versus-host disease. This guide provides a clear, step-by-step process to assist users in completing the form online efficiently and accurately.

Follow the steps to fill out the form successfully.

1. Click ‘Get Form’ button to obtain the form and open it in your document viewer.
2. Begin by entering the patient's information at the top of the form, including patient ID and relevant identifiers.
3. Review the Performance Score section. Choose the appropriate score based on the patient’s functional status using the provided KPS, ECOG, and LPS scales.
4. In the Skin section, assess the body surface area (BSA) involved and check all applicable skin features. Score based on observed symptoms and conditions.
5. Proceed to the Mouth section and indicate the presence of lichen planus-like features as well as symptoms affecting oral intake, scoring appropriately.
6. Navigate to the Eyes section. Mark any symptoms experienced and confirm if keratoconjunctivitis sicca has been diagnosed.
7. In the GI Tract section, check all symptoms that apply and document any significant impacts on daily living or nutrition.
8. Fill out the Liver section by selecting the appropriate bilirubin levels and corresponding symptoms affecting the patient.
9. Continue to the Lungs section, scoring symptoms and pulmonary function tests, ensuring to provide accurate respiratory assessment.
10. In the Joints and Fascia section, assess any symptoms and range of motion, recording the relevant scores.
11. Evaluate the Genital Tract section for any signs or symptoms, marking as applicable.
12. Finally, complete any additional indicators related to chronic GVHD that are relevant, scoring them based on their functional impact.
13. At the end of the form, review all information for accuracy. Once completed, save your changes, and you may download, print, or share the form as needed.

Complete your documentation online to ensure effective assessment and care management.