Click "YES" if you, your spouse, or your child's siblings have experienced the following allergy symptoms.
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Eczema (Skin Rashes)
A skin condition that can cause dry, red (inflamed) and itchy skin. Symptoms also include bumps, cracks and chips on the skin that usually occur in the neck, elbow, face, knees and hands.
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| Has the father experienced this symptom? | ||
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Asthma
A medical condition that causes difficulty in breathing. Symptoms include prolonged coughing, wheezing, and shortness of breath.
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Allergic Rhinitis
Also known as hay fever, it is a type of inflammation in the nose which occurs when the immune system overreacts to allergens in the air. Signs and symptoms include watery, red and/or itchy eyes, runny and itchy nose, sneezing and a blocked nose.
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| Has the mother experienced this symptom? | ||
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| Have the siblings of the child experienced this symptom? | ||
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Food Allergy
Occurs when the body's immune system reacts unusually to specific foods. Symptoms include itching in the mouth and throat, hives, blocked nose, vomiting and diarrhea, asthma attack and anaphylaxis (a very severe reaction that can cause loss of consciousness).
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| Has the mother experienced this symptom? | ||
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| Has the father experienced this symptom? | ||
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| Have the siblings of the child experienced this symptom? | ||