Chemotherapy Side Effect Journal Template

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Chemotherapy Side Effects Journal
Name ___________________________________________ Phone ____________________________________________
Hospital reference number & details ___________________________________________________________________
Keep track of any chemotherapy side effects you are experiencing, and share this information with your doctor
Common chemotherapy side effects include:
• Constipation
• Lost appetite
• Nausea/ vomiting
• Tiredness
• Fever
• Pain
• Loss of hair
• Sore mouth
Date/Time of
Chemotherapy
Chemotherapy Side Effect(s) Experienced

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