[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-563818-105":3,"detail-sidebar-cat-1-en-105":74,"doc-detail-563818-en":120},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":67,"head_meta":69,"extra_data":71,"updated_unix":73},105,"en","skin-test-results-for-food-allergens-medical-assessment-form","Skin Test Results for Food Allergens - Medical Assessment Form","","This document serves as an official clinical template for recording patient skin test results regarding potential food allergens. It includes structured sections for physician and patient information, a standardized reaction guide based on millimetre measurements, and dedicated tables for tracking test sites across four panels (A, B, C, and D) covering a wide array of common dietary allergens. 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High  \n7mm  \nHigh  \n5mm  \nModerate  \nPositive & Negative Control Test Results  \nPos.   mm  \nNeg.  mm  \nPediatric Testing  \nTesting protocol may need to be adjusted for children who cannot tolerate the 4-panel test (per the discretion of the treating physician) .  \nContact AllergyEasy  \nfor case-specific questions.  \n\n| PANEL-A |  |  |\n| --- | --- | --- |\n| SITE | ALLERGEN or EXTRACT | (mm) |\n| 1 | Apple |  |\n| 2 | Apricot |  |\n| 3 | Banana |  |\n| 4 | Barley |  |\n| 5 | String Bean |  |\n| 6 | Broccoli |  |\n| 7 | Cantaloupe |  |\n| 8 | Carrot |  |\n| 9 | Chocolate |  |\n| 10 | Corn |  |\n\n\n| PANEL-C |  |  |\n| --- | --- | --- |\n| SITE | ALLERGEN or EXTRACT | (mm) |\n| 21 | Tomato |  |\n| 22 | Watermelon |  |\n| 23 | Whole Wheat |  |\n| 24 | Beef |  |\n| 25 | Pork |  |\n| 26 | Chicken Meat |  |\n| 27 | Whole Egg |  |\n| 28 | Turkey |  |\n| 29 | Cow Milk |  |\n| 30 | Fish Mix |  |\n\nTesting Technician:    \nAntihistamine: Yes  No  \nAsthma: Yes  No  \nUnits Dispensed:    \nTesting Location:  \n Back  Right Arm  Left Arm  \n Other:    \n\n| PANEL-B |  |  |\n| --- | --- | --- |\n| SITE | ALLERGEN or EXTRACT | (mm) |\n| 11 | Garlic |  |\n| 12 | Grapefruit |  |\n| 13 | Mushroom |  |\n| 14 | Oat |  |\n| 15 | Orange |  |\n| 16 | Pineapple |  |\n| 17 | White Potato |  |\n| 18 | Rye |  |\n| 19 | Soybean |  |\n| 20 | Strawberry |  |\n\n\n| PANEL-D |  |  |\n| --- | --- | --- |\n| SITE | ALLERGEN or EXTRACT | (mm) |\n| 31 | Pea, Green |  |\n| 32 | Bean, Lima |  |\n| 33 | Buckwheat |  |\n| 34 | Cherry |  |\n| 35 | Cucumber |  |\n| 36 | Lemon |  |\n| 37 | Onion |  |\n| 38 | Spinach |  |\n| 39 | Cauliflower |  |\n| 40 | Rice Food |  |\n\n©2013 AllergyEasy of Arizona, Inc. All rights reserved. AllergyEasy and the AllergyEasy logo are trademarks or registered trademarks of AllergyEasy of Arizona, Inc.","cbCaidRqkTW0PTSn","https://ap.wps.com/l/cbCaidRqkTW0PTSn","pdf",203197,"English","# Reaction Guide\n## Control Test Results\n## Pediatric Testing Protocol\n## Allergen Panels\n### Panel A\n### Panel B\n### Panel C\n### Panel D\n## Clinical Observations","[{\"question\":\"How are test reactions interpreted?\",\"answer\":\"Reactions are measured in millimetres (mm), with 11mm indicating an extremely high reaction, 9mm very high, 7mm high, and 5mm a moderate reaction.\"},{\"question\":\"What should be recorded for control tests?\",\"answer\":\"The results for both positive and negative control tests should be documented by recording the corresponding millimetre (mm) measurements in the provided fields.\"},{\"question\":\"How should the protocol be handled for children?\",\"answer\":\"Testing protocols may be adjusted for children unable to tolerate the standard 4-panel test, subject to the treating physician's discretion.\"}]","Skin Test Results for Food Allergens - Medical Assessment Form | PDF"]