Get Allergy Skin Test Report Form Practice Name Ordering Physician: City State Street Address Zip

Filling out the Allergy Skin Test Report Form is an essential step in documenting patient allergy test results accurately. This guide provides step-by-step instructions to ensure you complete the form effectively and efficiently.

Follow the steps to correctly fill out the Allergy Skin Test Report Form online.

1. Click ‘Get Form’ button to access the Allergy Skin Test Report Form and open it in your preferred document editor.
2. Begin by filling out the 'Practice name' and 'Ordering physician' sections. Enter the relevant details to clearly identify the medical practice and the physician responsible for the test.
3. Complete the 'City', 'State', 'Street address', and 'Zip' fields to provide the full address of the practice. Ensure accuracy to avoid any potential miscommunication.
4. In the 'Telephone' and 'Fax' sections, provide the necessary contact information for the practice. This will facilitate any follow-up communications.
5. Enter the 'Patient name' and 'Date of birth' in the designated fields, along with the 'Patient number' to maintain patient confidentiality and tracking.
6. Document the 'Testing Technician's name' in the corresponding field. This identifies the person responsible for carrying out the skin tests.
7. Record the 'Last use of antihistamine (or other medication affecting response to histamine)' to ensure accurate interpretation of results. Include the number of days since the last use.
8. Fill in the 'Testing Date(s) and Time' for both percutaneous and intradermal tests to maintain a clear timeline of the testing procedure.
9. In the general information section, specify the details related to the skin test protocol, including allergen, testing concentration, extract company, and the injection method.
10. For the results section, accurately measure and record the longest diameter of the wheal and flare for both percutaneous and intradermal tests.
11. In the controls section, indicate the results of control tests, including negative and positive controls. Use standard abbreviations for clarity about the extract manufacturer.
12. After completing all fields, review the entire form for accuracy and completeness. Save your changes, and then download or print the form as needed for submission or records.

Complete the Allergy Skin Test Report Form online today to ensure accurate documentation of allergy testing.