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Exploring the Benefits of Calcium and Vitamin D Supplementation on Overall Health: A Retrospective Analysis

Patient No *

Patient Initials *

Date of Enrollment *

Investigator *

Site *

Demographic Information

Gender *

Male Female Other

Age (in Years) *

Height (in cm) *

Weight (in Kg) *

Date of Enrollment *

Medical History *

Presented complaints *

Diagnosis *

Co-existing Medical Conditions *

Concomitant medications *

Type of Calcium Supplementation: (Specify Brand)*

Dosage of Calcium Supplementation (Specify)*

Type of Vitamin D Supplementation (Specify Brand)*

Dosage of Vitamin D Supplementation (Specify Brand)*

Duration of Supplementation (Specify Brand)*

Adherence to Supplementation*

Excellent Good Fair Poor

Baseline Bone Mineral Density (BMD): (Specify)*

Follow-up BMD (if available): (Specify)

Fracture Incidence: (Specify)*

Muscle Strength Assessment (Handgrip Strength): (Specify)*

Balance Assessment: (Specify)*

Falls History *

Yes No

Serum Calcium Levels : (Specify)*

Serum Vitamin D Levels: (Specify)*

Pain (VAS Score) baseline and Pain (VAS Score) follow-up *

In general, current patient health after calcium & vitamin D3 supplementation *

(Excellent : 1 , Very good : 2, Good : 3, Fair : 4, Poor :5)

In general, current patient health after calcium & vitamin D3 supplementation *

Vitamin D levels after in second visit (6-12 months)	Improvement in overall health score over period of 12 months	Improvement in muscle Pain VAS (In case presenting symptom is pain)
ng/ml	%	%

Any adverse events related to vitamin D supplementation *