This form is not a diagnostic instrument and is only to be used within the context of your medical treatment and by you if you are greater than 18 years old. Share your checklist responses and assessment with your physician or other health care provider. The maker and provider of this form disclaims any liability, loss, or risk incurred as a consequence, directly or indirectly, from the use and application of any of this material.

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Share with your doctor

Your physician will want to see your M3 Monitor reports

The M3 Monitor provides a visual representation of your progress in a graphic form, showing clearly how your symptoms are responding to treatment, and whether and to what degree side effects have been a problem.

You may share these monitoring reports with your treating physician via hard copy, fax, email, or may be securely accessed through a Microsoft HealthVault account.

Your doctor may make use of this information to discuss with you if and when medication adjustments or psychotherapy are indicated.

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This form is not a diagnostic instrument and is to be used solely within the context of your medical treatment with your physician or other health care provider. The maker and provider of this form disclaims any liability, loss, or risk incurred as a consequence, directly or indirectly, from the use and application of any of this material. WhatsMyM3™ V.03.06 Copyright © 2002-2012 by M3 Information™, The M-3 Checklist and WhatsMyM3.com are free for personal home use. For any other uses, including clinical., educational, non-profit, hospital research, or for-profit settings please contact mail@m-3information.com. No further reproduction or distribution, or reverse engineering is permitted without written permission from M3 Information. Patent Pending.