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Patient Name: DOB: MR #: Index to Questionnaire HealthEncounterUW Health (University of Wisconsin Hospitals and Clinics Authority)ALLERGY ASTHMA AND IMMUNOLOGY QUESTIONNAIREDate: Referring/primary
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The u001671 allergy questionnaire 301733-dtnuv is a form designed to gather information about allergies for a specific individual.
Individuals who are responsible for the healthcare of the person with allergies are required to fill out the u001671 allergy questionnaire 301733-dtnuv.
The u001671 allergy questionnaire 301733-dtnuv can be filled out by providing details about the individual's allergies, triggers, symptoms, and medications taken for allergies.
The purpose of the u001671 allergy questionnaire 301733-dtnuv is to help healthcare providers and caregivers understand and manage the allergies of the individual effectively.
Information such as the types of allergies, triggers, severity of reactions, medications taken, and emergency contact information must be reported on the u001671 allergy questionnaire 301733-dtnuv.
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