Allergy test

Please fill in this test to know if you should go to an allergic examination!

1. Do you usually have nasal congestion?
Yes No

2. Do you sneeze, or do you have watery nasal discharge?
Yes No

3. Do your eyes itch or do you have red or irritant eyes?
Yes No

4. Can you feel that secretion is trickling in your pharynx?
Yes No

5. Are you suffering from sore throat?
Yes No

6. Do you usually caw, clear your throat?
Yes No

7. Have you got recurrent rash?
Yes No

8. Do you usually have bronchitis or tormenting cough?
Yes No

9. Do you suffer from asthma?
Yes No

10. Are you usually bloated?
Yes No

11. Do you have diarrhoea if you eat certain kind of food?
Yes No

12. If you are diagnosed that you are allergic, does your skin test older than 2 years?
Yes No

13. Do you have family members who are allergic?
Yes No

14. Do you have headache, tinnitus or bad malaise in a certain period of the year?
Yes No

15. Are you suffering from adenoids?
Yes No

16. Do you have chronic sinusitis or serous otitis media?
Yes No

17. Have you ever had tube in your ear?
Yes No

18. Are you suffering from migraine?
Yes No

19. Do you usually stay at dusty or musty places?
Yes No

20. Do you have an anti-allergic medicine which abolishes your symptoms?
Yes No