Intake Form

 

Please fill out this form and bring it to your initial appointment.

Medication Notice

Certain medications may interfere with allergy  testing!  Please read the following information before your first appointment.

The following medications interfere with skin allergy testing; therefore, we ask that you discontinue the following medications for three days prior to your initial visit and any subsequent skin testing visits:

  1. All antihistamines including Actifed, Alavert, Allegra, Allegra-D, Atarax,  Benadryl, Bromfed, Claritin, Cetirizine, Chlortrimeton, Claritin, Claritin-D, Deconamine, Dimetapp, Diphenhydramine HCl, Doxepin, Duradryl, Extendryl, Fexofenadine, Hydroxyzine, Kronofed-A, Levocetirizine Loratadine, PediaCare, Phenergan, Promethazine,  Rondec, Rynatan, Semprex-D, Tavist,  Triaminic, Vistaril, , Xyzal, Zyrtec and Zyrtec-D.
  2. Astelin, Astepro, and Patanase nasal sprays
  3. Over the counter sleep aids such as Tylenol PM

Do not stop Singulair or intranasal steroid sprays

Discontinue Clarinex for five days prior to your initial visit and any subsequent skin testing.

If you are scheduled for patch testing, please discontinue oral steroids.

If you are experiencing active hives, continue all medications. We urge you to keep any scheduled appointment even if you continue to take an antihistamine during those three days.  You should continue to take all asthma medications, including oral inhalers.  If you have any questions about a specific medication not mentioned, please call the office.


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