Allergy Quiz Allergy Screening Questionnaire Please help us understand the extent of your allergies and how it impacts your daily life. At the end of this screener, you can click “Print Results” to let your provider know how allergies are impacting your daily life. Welcome to your allergy derm quiz Name Email age Phone 1. Exposure History to Personal products which might contain allergens. Personal care products & Cosmetics. Shampoos Shower gel Hand Soap Makeups products Moisturizers Lotions Fragrances Body Mist Perfumes Deodorant Anti prespirant Fragrance containing cosmetics Hair Dyes Tattoos Disinfectants Detergents Fabric Softeners Soap Detergents Sun Exposure Sweating Pets 2. Site Of Use face hand UnderArms Foot Body Scalp 3. Have You Experienced any of the below symptoms Dryness Redness Itching Rashes Inflammations Scales Vesicles Time's up