• Allergy and Asthma Center, Anita N Wasan MD PLC

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  • Reason(s) for Visit:

  • Allergy and Asthma Center, Anita N Wasan MD PLC

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  • For those patients with hives, rashes, sensitive skin, and/or eczema:

  • Circle any symptoms that pertain to you:

    Headaches     Nasal congestion    Suicidal thoughts     Lymph node swelling

    Vision loss/changes   Trouble falling asleep    Nerve pain/tingling

    Breat lumps/masses   Hearing loss/changes    Trouble staying asleep 

    Arthritis/joint pain    Constipation    Sinus pressure    Snoring   Rash/eczema

    Diarrhea    Post nasal drip/throat closing   Mouth breathing    Hives     

    Bloating/gas   Cough    Heart palpiations   Difficulty in moving extremities

    Abdominal pain   Chest pain    Depression   Swelling   Nausea/vomiting

    Shortness of breath     Anxiety   Neck pain    Difficulty in urination

    Menstrual irregularities   Hair loss   Cold/heat intolerance   Thyroid problems

    Difficulty breathing   Frequent illnesses    Food allergies    Food sensitivities

     

     

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