Rash & Allergies

Which of the following symptoms do you suffer from?

What triggers your symptoms?

Please Please rate the severity of your symptoms




Please Approximately when did your symptoms start?




Please Which of the following apply to you?

Please Which of the following apply to you?

Please Do you already know which medications work well to treat your allergies?

Please If you've taken medications in the past, were they effective?

Please also list the medication names and how long you used them (or if you are still using them). If you haven't tried any treatments, you can leave this question blank.

Please Have you had nasal surgery (including sinus surgery, septoplasty, rhinoplasty, polyp surgery, turbinate surgery) in the past 3 months?

Please Have you been diagnosed with allergic rhinitis or seasonal/environmental allergies by a healthcare provider?

Would you like to share anything else with your provider through an upload?

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