Num Sum: Copy of allergy log


Allergy log - My allergy triggers and responses
TRIGGERS	ALLERGIC RESPONSES - CHECK ALL THAT APPLY
FOODS	Runny nose	Scratchy throat	Hives	Itching	Rash	Facial/neck swelling	Flushing	Abdominal pain or cramping	Constipation	Diarrhea	Difficulty breathing	Other
Shellfish
Peanuts
Eggs
Wheat
Soy
Other
BEVERAGES	Runny nose	Scratchy throat	Hives	Itching	Rash	Facial/neck swelling	Flushing	Abdominal pain or cramping	Constipation	Diarrhea	Difficulty breathing	Other
Beer
Other alcohol
Fruit juices with dyes
Milk products
Other
MEDICATIONS	Runny nose	Scratchy throat	Hives	Itching	Rash	Facial/neck swelling	Flushing	Abdominal pain or cramping	Constipation	Diarrhea	Difficulty breathing	Other
Antibiotics (name)
Pain medications (name)
Anesthetics (name)
Other
INSIDE ENVIRONMENT	Runny nose	Scratchy throat	Hives	Itching	Rash	Facial/neck swelling	Flushing	Abdominal pain or cramping	Constipation	Diarrhea	Difficulty breathing	Other
Dust
Mold
Cleaning products
Other
OUTSIDE ENVIRONMENT	Runny nose	Scratchy throat	Hives	Itching	Rash	Facial/neck swelling	Flushing	Abdominal pain or cramping	Constipation	Diarrhea	Difficulty breathing	Other
Pollen
Grasses
Trees
Other
ANIMALS	Runny nose	Scratchy throat	Hives	Itching	Rash	Facial/neck swelling	Flushing	Abdominal pain or cramping	Constipation	Diarrhea	Difficulty breathing	Other
Cats
Dogs
Insects
Other