Food Allergy Survey - Continued


Section 4. Food Allergies Details

4.1 What food(s) was the person allergic to when *first* diagnosed?

Cashew nut
Chicken
Cinnamon
Egg
Fish (e.g. cod, salmon)
Hazelnut
Lamb
Milk
Peanut
Rye
Sesame
Shell Fish (e.g. prawn, lobster)
Soy
Wheat
Other, please enter

4.2 What method was used for diagnosis?

Skin prick test
Food challenge (small amount of food given)
Blood tests
None, based on reactions
Other, please enter

4.3 What food is the person allergic to *now*?

Cashew nut
Chicken
Cinnamon
Egg
Fish (e.g. cod, salmon)
Hazelnut
Lamb
Milk
Peanut
Rye
Sesame
Shell Fish (e.g. prawn, lobster)
Soy
Wheat
Other, please enter

 

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