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Tell Your Story

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My Story — Looking Back

Complete what you remember. It is okay if you did not recognize the changes while they were happening. This form is designed to help you look back at the medication timeline and what changed.

1. Before the Medication

2. My Medication Timeline

3. What Changed?

Check anything you recognize now, even if it did not seem important at the time.

4. What I Believed at the Time

5. What Happened to My Life?

Check the areas that were affected.

6. In Retrospect

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