Autoimmune disease and hives list
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Personal Past Medical History or Current Disease (s) (Please Circle if Yes): Skin Cancer Y N HIV/AIDS Y N. Actinic Keratosis Y N Hepatitis C/Liver Disease Y N. Melanoma Y N Thyroid Disorders Y N. Cancer (other than skin cancer) Y N Diabetes Y N. Psoriasis Y N Kidney Disease Y N
[DOC File]Aesthetic and Clinical Dermatology Associates of Hinsdale
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Autoimmune Disease (lupus, rheumatoid arthritis) Endocrine Gland Disorders (thyroid, adrenal, pituitary) ... Please review the list of conditions and check the column(s) that most applies to you and your family history. ... Hives. Sores, boils, or sties . Slow …
[DOC File]The Immune System Part 2 - astephensscience
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Please list all drug allergies and describe your reaction to each one of them: hives/rashes/stomach problems/life threatening events that required ER visit or hospitalization. Name of Drug Type of Reaction
[DOCX File]Medical History - National Institutes of Health
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Hives, itching, swelling . Tightness of chest, difficulty breathing. Swelling of tongue. Dizziness, drop in BP. Anaphylactic shock. Unconsciousness or cardiac arrest. B. B. Edema. Localized s_____ due to the accumulation of _____ Can lead to tissue damage and eventual death if untreated. C. Autoimmune …
Chronic Autoimmune Illnesses Linked to Chronic Hives
History of autoimmune disease Current. Family history of autoimmune disease (biological relatives only, if applicable) Current. ... Hives. Condition active past one year. Condition currently active. Medications are taken for this condition. Medications taken daily for condition.
[DOCX File]irp-cdn.multiscreensite.com
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Are you currently seeing a chiropractor (if yes, list issue)? Are you currently seeing a physical therapist (if yes, list issue)? List Medications, Supplements, Homeopathics and Herbs (list reason for medication and any side effects e.g. drowsiness/dizziness, difficulty walking/standing, visual impairment, any other): List Surgeries with Dates:
[DOCX File]Medical Institute - Lamkin Clinic
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Allergy and Asthma Care. Patient Questionnaire. Patient Name _____ Birth Date _____ Referring Physician _____ Date Questionnaire Completed _____
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