Oral Food Challenge
A professional Allergy and Immunology template for healthcare professionals.
Preview template
Introduction
Dear Dr. [Referring Doctor's Last Name], I have the pleasure of seeing [Patient First Name] [Patient Last Name] for an oral food challenge today to [Challenge Food].
Oral Challenge Item
[Challenge Food]
Interval History
[Outline details of patient's food allergy. Provide a brief update on the patient's condition since the last visit, including any exposures, use of medication, and general well-being.]
Past Medical History
[List the past medical history and number them].
Current Medications
[List the current medications, including dose and frequency if available. Number the medications].
Medication Allergies
[List any known medication allergies or state 'NKDA' if none.]
Physical Examination
BP: [insert BP], HR: [Insert HR] BPM [Insert the following text without editing it: [insert patient's name] appears well. Head and neck examination was normal. Cardiac exam revealed a normal S1 and S2. Chest examination is clear with no wheezes or crackles. Skin examination did not reveal active eczema patches or urticaria lesions. The rest of the examination is unremarkable.
Investigations
[Include previous serum specific IgE testing and skin prick test results].
Procedure - Oral Challenge
[Insert the following text: Challenge Item: The risks and benefits of the oral food challenge were discussed with the patient today. Written informed consent was obtained. A graded oral challenge to (challenge food) was undertaken. [Patient's First Name] tolerated the challenge and monitored for sufficient time without any systemic reactions.]
Impression and Plan
[Summarize the findings of the oral challenge and provide recommendations for future management, including any dietary advice and follow-up instructions.]
Impression and Plan
[Summarize the findings of the oral challenge and provide recommendations for future management, including any dietary advice and follow-up instructions.]
Follow-up
[Insert this text: I will leave follow-up open at this time but would be happy to see him again in the future if the need should arise.]
Closure
[Insert the following text: I appreciate the opportunity to participate in [Patient's First Name] care, and I hope my suggestions are helpful. If any questions arise please feel free to contact my office.]
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How to use this template
This comprehensive new patient template helps establish care by capturing complete medical history, current concerns, and baseline health status. Use this for patients during their initial visit to create a thorough medical record.
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