Multiple sclerosis

Name:

Age

Gender

Feminine

Masculin

Other

Age of diagnostic

Which treatment / medicine.

Symptoms? Some examples

How does this disease affect you daily ?

Type of MS

Relapsing-Remitting

Secondary-progressive

Primary-progressive

How is your life’s quality at moment ?

How does your family help you? Is their support important to you?

In what aspects of life does MS most affect you?

Don’t hesitate adding more information :)

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