Drug Reaction Chart - Allergy Associates And Asthma (Page 2 of 2) in pdf

Drug Reaction Chart - Allergy Associates And Asthma Page 2

SURESH C. ANAND, M.D., M.S. IN MED., F.A.C.P., F.C.C.P.

F.A.C.A.A.I., F.A.A.A.A.I.

MIRIAM K. ANAND, M.D., F.A.C.P., F.A.C.A.A.I., F.A.A.A.A.I.

DIPLOMATE, AMERICAN BOARD OF INTERNAL MEDICINE

DIPLOMATES, AMERICAN BOARD OF ALLERGY & IMMUNOLOGY

1006 EAST GUADALUPE RD, TEMPE, AZ 85283

6553 EAST BAYWOOD AVE., STE 103, MESA, AZ 85206

VEENA KRAUSE, F.N.P.

2248 NORTH ALMA SCHOOL RD, STE 104, CHANDLER, AZ 85224

TERA CRISALIDA, P.A.-C., M.P.A.S.

TELEPHONE (MAIN OFFICE) (480) 838-4296 FAX (480) 820-1275

Instructions for Patient’s Being Evaluated for Drug Allergies

Dear Patient:

If you are coming to see us to be evaluated for possible drug allergies, please read

the following carefully.

There is currently little to no standardized testing available to test for drug allergies.

The physician will therefore rely heavily on the history you provide including the

medications to which you reacted, the events surrounding the reaction, and why the

medication was taken.

It is IMPERATIVE that you provide us with as much accurate information as you

can.

If possible, try to obtain the medical records that pertain to the reaction and bring

these with you to your first visit.

Please print a copy of the “Drug Reaction Chart” and fill it out as completely as

possible.

Bring it with you to your first visit.

Please print a chart for each

medication to which you reacted and fill each one out separately. This will greatly

assist us in helping you.

Thank you and please don’t hesitate to call us with any questions.

Drug Reaction Chart - Allergy Associates And Asthma Page 2