Form Id: SCR_HPV
ENGLISH FRANÇAIS PORTUGUÊS ITALIANO| Period (Visit type): | |
Referred reason: | |
| - for suspected cervical cancer: | |
| - for lesion greater than 75%: | |
| - for Endocervical canal lesion: | |
| - for colposcopy: | |
| - for other reason: | |
| Referred notes: | |
| Screening type: | |
| VIA/VILI: | |
| PAP smear: | |
| Colposcopy: | |
| Cervical Biopsy: | |
Treatment | |
| Cryotherapy: | |
| Thermoablation: | |
| LEEP: | |
Note: This is just a preview: not all features are guaranteed
