Allergy testing can be done in several ways depending on the type of allergy suspected. The following is a summary of the types of allergy tests that may be performed.

Prick Skin Testing

Prick skin testing is a quick, reliable and sensitive way to check for allergies. During the procedure, a small amount of the allergen is placed on the skin and the skin is gently pricked with the testing device. If the test is positive then an itchy bump develops that looks like a mosquito bite. The test takes approximately 20 minutes.

Prick tests are most commonly done on the back, however in some situations they are done on the arm. Patients who have significant amounts of back hair should shave their backs 2-3 days prior to testing.

Intradermal Skin Testing

Intradermal skin testing involves an injection of a small amount of the allergen under the skin. If the test is positive an itchy bump occurs similar to the prick test. Intradermal tests are done certain situations such as testing for bee/wasp allergy, drug allergy and vaccine allergy. Intradermal tests are sometimes done for inhalant allergens (pollens, pets, dust mites) if the prick tests are negative and there is a strong suspicion of an allergy.

Is Skin Testing Safe?

Skin testing is a safe way to check for allergies. However, in rare incidences skin testing may trigger significant allergic symptoms in highly allergic individuals. This occurs more frequently with intradermal skin tests.

Patch Testing

Patch testing is used to determine if a rash is due to skin contact with allergens, such as those present in make-up or soap. Patch testing involves placement of tape with small amounts of allergens present on the back. The skin is covered by a water tight bandage for several days.

Blood Tests

RAST testing may be done to detect IgE (the allergic antibody) to a specific allergen. RAST may not be as sensitive as skin testing for the detection of allergies. It may be used to supplement information from skin testing or if it is not possible to perform skin testing.

What to Expect From Your Breathing Tests

Spirometry- Estimated time 15 minutes. You will breath through a tube into a machine called a spirometer. Please check with us to see if there are any medications that need to be stopped.

Pre and Post Bronchodilator Spirometry- Estimated time 30 minutes. You will perform spirometry, be given an albuterol nebulizer treatment and then will have spirometry done again to see if it improves your lung function. Please check with us to see if there are any medications that need to be stopped.

Exercise Challenge- Estimated time 45 minutes. You will perform spirometry, then run up and down stairs or on a treadmill until you have symptoms of asthma/shortness of breath. Spirometry will then be repeated. If necessary you may be given albuterol and spirometry done a 3rd time. Please check with us to see if there are any medications that need to be stopped.

Methacholine Challenge- Estimated time 90 minutes. You will perform serial spirometry measurements after breathing in a medication called methacholine. Methacholine causes lung function to decrease in asthmatics. The medicine is short acting and reversible. Please check with us to see if there are any medications that need to be stopped.

6 minute walk- Estimated time 10 minutes. You will walk quickly for 6 minutes. Your oxygen level and pulse will be measured and recorded every minute.

Medications to Stop Prior to Allergy Testing

The following is a list of medications that needs to be stopped before skin testing in order to obtain accurate results. If you have concerns about stopping any of the following medications please discuss them with your physician and let us know.

Medications to Stop 7-14 days prior to Testing

Amitryptyline (Elavil)
Clomipramine (Anafranil)
Doxepin (Sinequnan)
Imipramine (Tofranil)
Trimipramine (Surmontil)
Amoxapine (Asendin)
Desipramine (Nupramin)

Nurtiptyline (Pamelor, Aventyl)
Protriptyline (Vivactil)
Maprotiline (Ludiomil)
Mirtazapine (Remeron)
Trazadone (Desyrel)
Nefazadone (Serzone)

*Please consult with your physician before stopping any of these medications if you take them on a regular basis.

Medications to stop 5-7 days prior to Testing

Claritin (Loratidine)
Allegra (Fexofenadine)
Clarinex (Desloratidine)

Medications to Stop 3- 4 days prior to Testing

Actifed, Dimetapp( Brom-pheniramine)
Atarax, Vistaril (Hydroxyzine)
Benadryl (Diphenhydramine)
Chlortrimetron (Chlorpheniramine)
Phenergan (Promenthazine)
Tavist, Antihist (Clemastine)

Zyrtec (Cetirazine)
Compazine (Prochlorperazine)

Medications to Stop the day before Testing

Singulair (montelukast)
Reglan (metoclopramide)
Prevacid

What medications can be taken? It is okay to continue nasal sprays (ie Flonase, Rhinocort,

Nasonex, Nasacort) and it is okay to take pseudoephedrine. Singulair is another option that may be used until the evening before your skin testing appointment. It is also okay to continue taking your inhaled asthma medications.

Allergy Web Links

National Groups with a Variety of Topics

American Academy of Allergy, Asthma & Immunology

www.aaaai.org

American College of Allergy, Asthma and Immunology

www.acaai.org

Allergy & Asthma Network

Mothers of Asthmatics

www.aanma.org

American Lung Association

www.lungusa.org/

National Institutes of Health

http://www.nhlbi.nih.gov/

Food Allergy

Food Allergy and Anaphylaxis Network

www.foodallergy.org

Allergy Kids

www.allergykids.com

Hives (Urticaria) & Angioedema

Hereditary Angioedema Association

www.hereditaryangioedema.com/

International Chronic Urticaria Society

www.urticaria.thunderworksinc.com

Immune Deficiency

Immune Deficiency Foundation

www.primaryimmune.org

Pollen Counts

National Allergy Bureau

www.aaaai.org/nab/index.cfm?p=allergenreport

National Jewish Medical and Research Center

www.njc.org/news/pollen.aspx

Air Quality

Environmental Protection Agency

http://airnow.gov/

Allergy Products

Achoo Allergy

www.achooallergy.com

Allergy Solutions

www.allergysolution.com

Mission Allergy

www.missionallergy.com

Enjoy Life Foods

www.enjoylifefoods.com

Allergy Grocer

www.allergygrocery.com

Allergy Web Links

National Groups with a Variety of Topics

American Academy of Allergy, Asthma & Immunology

www.aaaai.org

American College of Allergy, Asthma and Immunology

www.acaai.org

Allergy & Asthma Network

Mothers of Asthmatics

www.aanma.org

American Lung Association

www.lungusa.org/

National Institutes of Health

http://www.nhlbi.nih.gov/

Food Allergy

Food Allergy and Anaphylaxis Network

www.foodallergy.org

Allergy Kids

www.allergykids.com

Hives (Urticaria) & Angioedema

Hereditary Angioedema Association

www.hereditaryangioedema.com/

International Chronic Urticaria Society

www.urticaria.thunderworksinc.com

Immune Deficiency

Immune Deficiency Foundation

www.primaryimmune.org

Pollen Counts

National Allergy Bureau

www.aaaai.org/nab/index.cfm?p=allergenreport

National Jewish Medical and Research Center

www.njc.org/news/pollen.aspx

Air Quality

Environmental Protection Agency

http://airnow.gov/

Allergy Products

Achoo Allergy

www.achooallergy.com

Allergy Solutions

www.allergysolution.com

Mission Allergy

www.missionallergy.com

Enjoy Life Foods

www.enjoylifefoods.com

Allergy Grocer

www.allergygrocery.com

Adult Allergy New Patient Questionnaire

Name:

Age:

Date of Appointment:

Instructions: Please complete the following questionnaire as it is pertinent to the individual being evaluated. Completion of this form will assist us in evaluating and treating your allergy problem. Please bring the completed form with you to your appointment. Thank you.

Briefly describe the main reason for your visit and what you hope to accomplish.

Have you ever had any of the following problems? Please check all items either Y, N or unsure
Condition	Y	N	Unsure	Age at Onset	Comments
Asthma (Wheezing)
Other Breathing problems (cough, shortness of breath, frequent “chest colds”)
Sinus infections
Nasal Polyps
Hay fever (runny/stuffy/itchy nose)
Hives or swelling
Eczema
Reactions to Foods (please list)
Reactions to Drugs (please list)
Reactions to Insect Stings
Additional Comments:

Have you ever had any of the following symptoms?
Symptoms	Y/N	How many days in the last month	Severitymild, moderate, severe	Worst SeasonSpring, Summer, Fall, Winter	Comments
Runny or stuffy nose
Itchy nose
Sneezing
Eyes: itching, watery
Wheezing
Coughing
Wheezing or cough with exercise
Night time awakenings due to shortness of breath or cough
As sensation of choking or difficulty getting air in
Skin problems

Exacerbating Factors (Triggers)
Please check each symptom box that that applies with exposure to the following:	Symptom
	Asthma	Nose/Sinus/Eyes	Eczema	Hives	Comments
Animals (please name)
Pollens/molds/mildews
Respiratory infections, “Colds”
Exercise
Cold Air
Foods
Dust
Air Pollution
Fumes/Odors/Scents
Car/Truck Exhaust
Weather Changes
Aspirin/Aspirin like drugs (ie ibuprofen, naproxen)
Emotions/Stress
Hormone changes/ menstruation
Medications (please name)
Work- related (please name)
Other:

Previous Allergy Evaluation and Therapy *Please bring copies of results if possible

Allergy Skin Tests? Yes No Dates:

Allergy RAST Testing? Yes No Dates:

Allergy Injections? Yes No Dates: Start: End:

Chest X-ray or CT scan? Yes No Dates:

Sinus X-ray or CT scan? Yes No Dates:

Have you ever needed sinus surgery? Yes No Dates:

Other:

Medications: Please list any medications that you are currently taking for allergies (including inhalers, over the counter medications or herbal medicines) and any medications for other reasons.
Current Allergy Medications			Other Medications
Name	Dose	Times per Day	Name	Dose	Times per Day







Please list any Allergy Medications you have tried in the past.


Have you ever needed to take Oral Steroids for an allergic condition? (for example prednisone, dexamethasone)

Past Medical History: Please list any other illnesses or chronic medical conditions you have had.
Please list any other illnesses or chronic medical conditions you have had:



Please list all hospitalizations/surgeries: Please give reason and date



Immunizations:
Are they up to date?
Have you received a Pneumovax? Date:
Do you receive a yearly influenza vaccine? Date: of last injection:

Family History
Please list family members with any of the following:
Asthma		Emphysema
Hayfever		Autoimmune diseases
Eczema		Cancer
Food Allergies		Heart Disease
Hives		Diabetes
Cystic Fibrosis		Glaucoma
Recurrent infections		Other

Social History:
Marital Status: Single Married/Partner Divorced Separated Widowed
Occupational History: (please list most recent job first)
Job Title/Description	Dates	Please list any health risks/exposures



Has your illness impacted your job performance?
Do you have any hobbies that have potential exposures and/or affect your symptoms?
Do you or have you ever smoked cigarettes? Number of years: Avg # of cigarettes/day: Age Quit: Current # of cigarettes/day:
Other tobacco use? Type: Amount:
Have you/do you have second hand smoke exposure?
Do you have a history of any other type drug use (ie marijuana, cocaine)? Yes No If yes what type and was it inhaled or IV?
Average amount of alcoholic beverages per week:

Environmental History
Residence: Please list your current/past residences (city, state) with the current address first
City/Town & State		# of Years	Effect on Symptoms/Exposures



Please check all that apply regarding your current residence:
	Smokers in home?			Wall-to-wall carpet?
	Pets/Birds in home? (what?)			Do you vacuum?
	Swamp Cooler?			Air purification system?
	Air conditioning?			Pillow and mattress encasings?
	Humidifier?			Leaking roof or basement?
	Heating? (type: forced air, electric, water)			Mold or Mildew?
	Fireplace? (type: gas or wood burning)			Located near a busy road?
	Wood burning stove?			Other:

Pediatric Allergy New Patient Questionnaire

Name:

Age:

Date of Appointment:

Instructions: Please complete the following questionnaire as it is pertinent to the individual being evaluated. Completion of this form will assist us in evaluating and treating your child’s allergy problem. Please bring the completed form with you to your appointment. Thank you.

Briefly describe the main reason for your visit and what you hope to accomplish.

Has your child ever had any of the following problems? Please check all items either Y, N or unsure
Condition	Y	N	Unsure	Age at Onset	Comments
Asthma (Wheezing)
Other Breathing problems (cough, shortness of breath, frequent “chest colds”)
Sinus infections
Nasal Polyps
Hay fever (runny/stuffy/itchy nose)
Hives or swelling
Eczema
*Reactions to Foods (please list below)
Reactions to Drugs (please list)
Reactions to Insect Stings
Additional Comments:

*Food Allergies: List any foods to which your child has had an adverse reaction. If none leave blank.
Food	Age at time of reaction	Symptoms (i.e. eczema, hives, swelling, asthma)

Has your child ever had any of the following symptoms?
Symptoms	Y/N	How many days in the last month	Severitymild, moderate, severe	Worst SeasonSpring, Summer, Fall, Winter	Comments
Runny or stuffy nose
Itchy nose
Sneezing
Eyes: itching, watery
Wheezing
Coughing
Wheezing or cough with exercise or play
Noisy breathing
Turning blue due to shortness of breath
Chest tightness
Night time awakenings due to shortness of breath or cough
Skin problems
Snoring

Exacerbating Factors (Triggers)
Please check each symptom box that that applies with exposure to the following:	Symptom
	Asthma	Nose/Sinus/Eyes	Eczema	Hives	Comments
Animals (please name)
Pollens/molds/mildews
Respiratory infections, “Colds”
Exercise
Cold Air
Foods
Dust
Air Pollution
Fumes/Odors/Scents
Car/Truck Exhaust
Weather Changes
Aspirin/Aspirin like drugs (i.e. ibuprofen, naproxen)
Emotions/Stress
Hormone changes/ menstruation
Medications (please name)
Work- related (please name)
Other:

Previous Allergy Evaluation and Therapy *Please bring copies of results if possible

Allergy Skin Tests? Yes No Dates:

Allergy RAST Testing? Yes No Dates:

Allergy Injections? Yes No Dates: Start: End:

Chest X-ray or CT scan? Yes No Dates:

Sinus X-ray or CT scan? Yes No Dates:

Have you ever needed sinus surgery? Yes No Dates:

Other:

Medications: Please list any medications that your child is currently taking for allergies (including inhalers, creams, over the counter medications or herbal medicines) and any medications for other reasons.
Current Allergy Medications			Other Medications
Name	Dose	Times per Day	Name	Dose	Times per Day







Please list any Allergy Medications tried in the past.


Has your child ever needed to take Oral Steroids for an allergic condition? (for example Orapred)

Birth History

Place of Birth: (city/state)

Length of Pregnancy:

Type of Delivery:

Complications:

Developmental concerns:

Diet History

Breast fed? If so until what age.

Type of formula used (please indicate if soy, cow’s milk , rice based, elemental):

Age at which solids were introduced:

Are any foods currently avoided? (please name)

Past Medical History: Please list any other illnesses or chronic medical conditions your child has had.
Please list any other illnesses or chronic medical conditions your child has had:



Please list all hospitalizations/surgeries: Please give reason and date.



Immunizations:
Are they up to date?
Influenza vaccine? Date: of last injection:

Family History
Please list family members with any of the following: (siblings, parents, aunts, uncles, grandparents)
Asthma		Emphysema
Hay fever		Autoimmune diseases
Eczema		Cancer
Food Allergies		Heart Disease
Hives		Diabetes
Cystic Fibrosis		Glaucoma
Recurrent infections		Other

Social History

Child’s primary caretaker(s):

Caretaker(s) occupation(s):

Who lives at home?

Does your child attend day care or school?

Are there any smokers at home or anywhere else your child spends time?

How many days of school has your child missed as a result of his/her illness in the past year?

What activities or sports does your child engage in?

Environmental History
Residence: Please list your current/past residences (city, state) with the current address first
City/Town & State		# of Years	Effect on Symptoms/Exposures



Please check all that apply regarding your current residence:
	Smokers?			Wall-to-wall carpet?
	Pets/Birds? (what?)			Hard wood/tile floors?
	Swamp (evaporative) Cooler?			Air purification system?
	Air conditioning?			Pillow and mattress encasings?
	Humidifier?			Leaking roof or basement?
	Heating? (type: forced air, electric, water)			Mold or Mildew?
	Fireplace? (type: gas or wood burning)			Located near a busy road?
	Wood burning stove?			Other: