Symptoms

Do you suffer from:
Sneezing? Itchy, runny, or blocked nose? Itchy skin rashes?

Fill in the questionnaire below, print it out and take it to your pharmacy or doctor for professional allergy advice.

Hayfever and allergy symptom sheet

Take control of your allergies.

Complete this allergy sheet by clicking on the relevant options, print it out and share it with your pharmacist or doctor.

Your healthcare professional will advise you of the best treatment for you.

1. What symptoms do you currently experience?

   	Sneezing		Runny nose		Nasal itching
   	Watery eyes		Itchy eyes		Nasal congestion
   	Itchy skin rash

2. When do you experience your hayfever and allergy symptoms?

   	Spring		Summer		Autumn
   	Winter		All year round

3. When are your symptoms most severe?

   	Spring		Summer		Autumn
   	Winter		All year round

4. What triggers make your symptoms worse?

   	Pollen		Grass		Pet hair
   	Mould		Carpet		Other

5. What medications are you currently using to treat your allergy and hayfever symptoms?

   	Antihistamines		Non-prescription nasal sprays
   	Prescription nasal sprays		Other medications
   	I’m not using medication for my allergy symptoms

6. If you do take medication for your hayfever and allergy symptoms, how often do you take them?

   	Every day of the year		Every day of hayfever season
   	Every few days		Once in a while

7. If you do take medication for your hayfever and allergy symptoms, how satisfied are you with that treatment?

   	Very unsatisfied		Somewhat unsatisfied		Impartial
   	Somewhat satisfied		Very satisfied