Questionnaire allergies

By means of the questions below, we would like to make a first assessment of the severity of the allergy. Please complete the following questionnaire prior to your first appointment at the hospital. Where the text says "you", this also means "your child".

Thank you and we look forward to seeing you at the Paediatric Outpatient Clinic of Amstelland Hospital.

Inhaled allergy / possible hay fever symptoms




Other allergies

Medical information