ASA Allergy Symptom Checker

1

During the past week, how often did you have nasal congestion?Choose the response that best describes your nasal and other allergy symptoms that are not related to a cold or the flu.

5 - Never

4 - Rarely

3 - Sometimes

2 - Often

1 - Extremely Often

2

During the past week, how often did you sneeze?Choose the response that best describes your nasal and other allergy symptoms that are not related to a cold or the flu.

5 - Never

4 - Rarely

3 - Sometimes

2 - Often

1- Extremely Often

3

During the past week, how often did you have watery eyes?Choose the response that best describes your nasal and other allergy symptoms that are not related to a cold or the flu.

5 - Never

4 - Rarely

3 - Sometimes

2 - OFTEN

1 - Extremely Often

4

During the past week, to what extent did your nasal or other allergy symptoms interfere with your sleep?Choose the response that best describes your nasal and other allergy symptoms that are not related to a cold or the flu.

5 - Not at all

4 - A little

3 - Somewhat

2 - A lot

1 - All the time ALL THE TIME

5

During the past week, how often did you avoid any activities (for example, visiting a house with a dog or cat, gardening) because of your nasal or other allergy symptoms?Choose the response that best describes your nasal and other allergy symptoms that are not related to a cold or the flu.

5 - Never

4 - Rarely

3 - Sometimes

2 - Often

1 - Extremely

6

During the past week, how well were your nasal or other allergy symptoms controlled?Choose the response that best describes your nasal and other allergy symptoms that are not related to a cold or the flu.

5 - Completely

4 - Very

3 - Somewhat

2 - Often

1 - Not at all

7

Symptom Checker ResultsPLEASE REMEMBER THIS NUMBER AND TALK WITH YOUR ALLERGIET

8

Allergist on Demand

First Name

Last Name

9

Please tell us your first name* This field is required.PLEASE SHARE FIRST NAME AND EMAIL BELOW

First Name

Email Address