Self Assesment Form

This self assessment tool has been devised by the fellow patient members of the Patient Advisory Board of the CML Society of Canada. The goal of the assesment guide is to help you review and assess key indicators to measure your quality of life. You can combine it with the use of the E-Diary.

We hope you find it useful in helping you to think about any particular side effect you may want to talk to your Doctor about.

We would like to point out, that while most patients do have some type of side effect we cannot conlude that they are particularly due to the treatment or even the disease itself.

You should review the self assessment guide before your next visit with your Doctor. Remember to take notes and follow up on any advice your Doctor may provide you to help you manage your side effects.

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