Tobacco Implementation Guide-Concomitant Medications
Any Concomitant Medications
Were any concomitant medications/products taken?	No  Yes
Medications
What is the category for the concomitant medication/product?
What is the line number?
What was the medication/product?
For what indication was the medication/product taken?
What was the individual dose of the medication/product?
What is the unit?
What was the dose form of the medication/product?
What was the route of administration of the medication/product?
What was the frequency of the medication/product?
What was the medication/product dose start date?	01 Jan 2000
Is the medication/product ongoing?	No  Yes
What was the end date?	01 Jan 2000

* Mandatory field