Allergy Drops Questionnaire

Gradient Top Gradient Bottom
About Dr. Mitchell AppointmentsAllergy Detective Blog Contact
1.866.633.7677

Questionnaire for patients on Allergy Drops

  1. (required)
  2. (required)
  3. 1. Did you miss more than 2 weeks of your allergy extracts?
  4. 2. Are you taking any new medications since your last office visit?
  5. If yes, please name:
  6. 3. Is there any change in your physical health: pregnancy, ill health?
  7. 4. Did you note any adverse reaction while using the last set of extracts?
  8. I acknowledge receiving the extracts (drops).
  9. Captcha
 

cforms contact form by delicious:days

Common Allergies NYC Allergy Doctor

New York Office
57 West 57th St, Suite 601,
NYC NY 10019
Call: 212.397.0157

Rockville Center Office
165 North Village
Avenue, Suite #129
Rockville Centre, NY 11570
Call: 516.678.9600

Allergy Relief
“Dr. Skype” will see you now: Yikes!

I am all for advances in technology – it is what makes medicine more of a science than an art – but… I think we… read more

Dangerous sinus infections you need to know about

The past month I have diagnosed two patients with sinus infections due to Methicillin-resistent Staphylococcus Aureus. The medical lingo for these type of infections is MRSA… read more

Read all articles
Allergy Resources
Allergy Treatment