• Patient Information - Natural Allergy Drops

    A. Mastrosimone M.D | Franklin Corner Road, Lawrenceville, N.J. 08648 | Telephone: 609-896-2300
  • Date of Birth
     - -
  • Format: (000) 000-0000.
  • Sex
  • Select all that apply - symptoms are worse with
  • Are symptoms becoming worse each year?
  • Symptoms are better or improve:
  • Select any or all medication or treatment that helps or relives your symptoms:
  • Were you ever tested for allergies?
  • Were you tested more than once?
  • Did you have reactions to any of the following?
  • Were you ever on allergy shots or injections?
  • Do you have or was an Epipen prescribed for food allergies?
  • Do your allergies cause eye symptoms?
  • Do you use eye drops?

  • Nasal Symptoms

  • Nasal congestion - Check all that apply
  • Do you have any of the following sinus symptoms?
  • Do you have migraine headaches?
  • Are antibiotics prescribed for sinus infections?
  • Have you had X-rays or CT scans of your sinuses?
  • Have you ever had sinus surgery?
  • Do you have postnasal drip, mucus in the throat, frequent throat cleaning?
  • Do you smoke?
  • Do you have asthma?
  • If you have asthma, are symptoms...
  • I have symptoms
  • Does asthma medication help or reduce your symptoms?
  • Do you live in a
  • Is there carpeting in bedrooms, living areas etc?
  • If you have a basement, is it damp, musty, or moldy?
  • Any pets in the home?
  • Do any pets sleep in the bedroom?
  • If you have a reaction to dogs/cats etc.

  • Please read carefully before using this site.
    Thank you for visiting Naturalallergydrops.com (the "Web Site"), which is owned and operated by Angelo Mastrosimone, M.D..The Web Site is designed to help you learn more about the oral treatment of allergic diseases. We offer the Web Site to you, the user, conditioned upon your acceptance of all of the terms, conditions, policies and notices stated on the Web Site. We do not support any claims to diagnose, treat, or cure any medical condition or disease. By using this Web Site, you signify your assent to these Terms and Conditions and any subsequent modifications. These Terms and Conditions constitute a binding agreement with you; if you do not accept all of these Terms and Conditions, please exit the Web Site immediately.

    We do not support any claims to diagnose, treat, or cure any medical condition or disease.

  • I agree to the above terms.
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