Allergy Testing Consult (Sea to Sky)

OVERALL_INSTRUCTIONS

Chief Complaint

Consult Letter Template

Template

Dear [Referring Clinician] Thank you for referring [Patient Name] to see me. This [pleasant/appropriate descriptor] [Patient Age] year old has presented for [Allergy Testing Consult Purpose, for example epicutaneous prick allergy testing]. [Provide a detailed narrative of the patient's allergy symptoms, including specific symptoms, timing, and seasonality. Include information on any medications taken or not taken, environmental factors, and living conditions that may influence symptoms. Note any uncertainties the patient has about symptom improvement in different environments.] For example: [Patient Name] has [symptoms]. These symptoms are [timing/seasonality]. [Patient Name] does not take [medications]. [He/She/They] reports that [symptom details]. There is no exposure to [environmental factors]. [Patient Name] lives in [living environment details]. [He/She/They] is unsure if [symptoms improve/worsen] when [specific conditions]. Allergy Testing: [Testing Type] [Patient Name] was tested today for [list of allergens]. [Testing Results — Positive histamine. Negative control.] For example: Allergy Testing: Epicutaneous Prick [Pronoun] was tested today for Timothy Grass, White Oak, Western Cottonwood, Alder, Box Elder, Western Juniper, Pine, Pigweed, Plantain, Ragweed, Sheep Sorrel, Sagebrush, Thistle, Alternaria Tenius, Aspergillus Fumigatus, Helminthosporium, H. Cladosporiodes, Mite D. Farinae, Mite D. Pteronyssinus, Cockroach, Cat and Dog. Positive histamine. Negative control. On Examination: Left Ear: External Canal: [Describe condition, e.g., normal, any abnormalities] Tympanic Membrane: [Describe condition, e.g., normal, any abnormalities] Right Ear: External Canal: [Describe condition, e.g., normal, any abnormalities] Tympanic Membrane: [Describe condition, e.g., normal, any abnormalities] Nose: Turbinates: [Describe condition, e.g., normal, any abnormalities] Fiberoptic: [Findings — if not provided, default to "normal"] Oral Cavity: [Describe condition, e.g., normal, any abnormalities] Tonsils: [Grade and describe condition] Results: [Summarize test results, including any positive findings and additional observations such as dermatographism.] Impression: [List the patient's current diagnoses or clinical impressions. Include any relevant details or considerations for each condition listed.] 1. [Impression/Diagnosis: relevant details or considerations] 2. [Impression/Diagnosis: relevant details or considerations] Plan: [For each treatment plan, provide a concise description including the medication or therapy name, dosage or frequency, duration, and any specific instructions or patient preferences. Include follow-up plans with specific time frames.] 1. [treatment plan 1: concise summary] 2. Thank you for involving me in the care of your patient. Dr. Maureen Harriman