Allergies

Which of the following symptoms do you suffer from?

What triggers your symptoms?

Please rate the severity of your symptoms.

Approximately when did your symptoms start?




Which of the following apply to you?





Which of the following apply to you?

Have you had nasal surgery (including sinus surgery, septoplasty, rhinoplasty, polyp surgery, and turbinate surgery) in the past 3 months?

Have you been diagnosed with allergic rhinitis or seasonal/environmental allergies by a healthcare provider?

Do you already know which medications work well to treat your allergies? If yes, please list the medications, how long you have used them for, and if you are still currently using them.

Is there anything else related to treatment that you'd like to ask or discuss with your medical provider?

Do you have a preferred medication?




Would you like to share anything else with your provider through an upload?

Cancel Visit

Do you want to cancel the visit?


Cancel Visit

Do you want to cancel the visit?