1.
Have you ever had an allergic reaction to any of the following? (Select all that apply)
2.
Do any of your family members have a history of hereditary angioedema or allergic reactions?
3.
Have you ever experienced hives or unexplained swelling, especially around the hands, feet, lips, or eyes?
4.
Have you ever been diagnosed with an illness or infection such as leukemia or lupus?
5.
Do you often experience stomach cramping, discolored rashes, or patches on your limbs without any known cause?
6.
Have you ever had difficulty breathing, hoarseness, or a swollen throat after coming in contact with potential allergens?
