


Reflux Log
π₯ GERD Symptom Log β VA Disability Claim PDF Tracker πΊπΈ
This printable GERD (Gastroesophageal Reflux Disease) log is specifically designed to help veterans track daily symptoms, medication use, and impact on quality of life β perfect for submitting with your VA disability claim or appeal.
π Whatβs Inside:
β
Daily fields for heartburn, regurgitation, chest pain, bloating, nausea, and more
β
Space to log frequency, severity, and meal triggers
β
Medication tracking with response notes
β
Notes section for functional impact (e.g., sleep disruption, missed work, diet changes)
β
Clean, clinical layout for easy sharing with your VSO or medical provider
β
Designed in line with VA evaluation criteria for GERD-related claims
π₯ Instant PDF download β print and fill out as often as needed
π₯ GERD Symptom Log β VA Disability Claim PDF Tracker πΊπΈ
This printable GERD (Gastroesophageal Reflux Disease) log is specifically designed to help veterans track daily symptoms, medication use, and impact on quality of life β perfect for submitting with your VA disability claim or appeal.
π Whatβs Inside:
β
Daily fields for heartburn, regurgitation, chest pain, bloating, nausea, and more
β
Space to log frequency, severity, and meal triggers
β
Medication tracking with response notes
β
Notes section for functional impact (e.g., sleep disruption, missed work, diet changes)
β
Clean, clinical layout for easy sharing with your VSO or medical provider
β
Designed in line with VA evaluation criteria for GERD-related claims
π₯ Instant PDF download β print and fill out as often as needed