Get 33500283-1a-de Fragebogen Bei Anaphylaxie F R Die Arztpraxis - Anaphylaxie

This guide will help you navigate the 33500283-1a-DE Fragebogen Bei Anaphylaxie F R Die Arztpraxis - Anaphylaxie form online. By following these detailed instructions, you can ensure that all necessary information is accurately submitted.

Follow the steps to complete your anaphylaxis questionnaire online.

1. Click the ‘Get Form’ button to access the form and open it in your document editor.
2. Start by filling out Section 1, which pertains to the anaphylactic reaction. You will need to indicate the type of reaction that occurred by checking the appropriate boxes for options such as skin/mucosal, gastrointestinal, or respiratory symptoms.
3. In Section 1.2, indicate whether the outcome of the reaction was lethal by selecting 'Yes' or 'No'.
4. Move to Section 1.3 to specify where the reaction took place by selecting from listed locations, or indicate another location if necessary.
5. Section 1.4 asks if this was the first occurrence of the reaction. Please select 'Yes', 'No', or 'Unknown' as appropriate.
6. Proceed to Section 2 to detail the diagnostic measures that were conducted. Check all applicable tests such as personal history, skin test, or specific IgE determination.
7. In Section 3, indicate whether the trigger for the reaction is known. You may specify allergens under sections for food, medication, insect venom, and so on.
8. Section 4 requires you to identify any co-factors that may have contributed to the reaction. Select any applicable options and provide additional information where applicable.
9. Complete the sections requiring pseudonymized patient data, ensuring all required fields are filled out, including the initials for the patient's name, birthdate, and date of reaction.
10. Once all sections are completed, review the information for accuracy. You can then save your changes, download, print, or share the completed form as needed.

Complete your document online to support anaphylaxis data collection.