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Allergy History Form

Asks about drug allergies, food allergies, and environmental allergies. Built for allergy and immunology practice intake documentation.

Questions
10
Page
1
Time
about 3 min

Includes

  • E-signature
  • Allergy list
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Your practice

Allergy History Form

Live preview. Tap through it like a patient.

Who it is for

  • Allergy and immunology practice intake documentation
  • Primary care allergy record updates and reconciliation
  • Emergency department triage allergy verification
  • Pre-procedural allergy screening for contrast and latex

What's inside

  1. Full NameText · Required
  2. Drug AllergiesAllergies
  3. Food AllergiesAllergies
  4. Environmental AllergiesAllergies
  5. Contact Allergies (Latex, etc.)Allergies
  6. Reaction Severity & TypeLong Text
  7. Allergy Testing ResultsAllergies
  8. Current ImmunotherapyLong Text
  9. Epinephrine Auto-Injector PrescribedLong Text
  10. Patient SignatureE-Signature

From form to a ready patient

  1. The Formisoft form builder with editable questions and required toggles

    01

    Make it yours

    Reword, reorder, or add to the Allergy History Form, and add your logo.

  2. A patient filling out a Formisoft form on a phone

    02

    Patients finish it at home

    A secure link by text or email, filled out on their phone before the visit. No app.

  3. The Formisoft dashboard showing how many of today's patients are ready

    03

    Your team sees who is ready

    Each visit shows as ready once its forms are in. Answers land on the patient record.

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Questions

Responses are encrypted, only your team can see them, and a BAA is included.

Yes. You can add, remove, reorder, or reword any of the 10 fields. You can also add conditional logic, new pages, file uploads, e-signatures, and payment fields.

Yes. Attach the form to a visit type and every patient who books gets it right away, with a reminder before the visit if it is not done. Your calendar shows which visits are ready.

Send it before the visit, so patients arrive ready.

Book a short call and we will set up the Allergy History Form for your practice, ready to send before the next visit.

BAA included · We set up your front desk

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