Contribute Your Wheat Allergy Symptom to Food allergy Relief Page

Your allergic reactions to wheat; enter your data and conclusions. Revised 4/15/98

"Food Allergy Relief Sharing" a personal www site

Hula Dancer

For Your report, Send a Copy of Rows 1,2, and 8

Hawaii

The other rows are for your own records

Row 1 A B C D E F G H

Row 2 Food Trial Number    Part of
body
affected
more
than any other
part is:
Be
specific   System
of body
affected
more
than any other.
Be
specific   Type of reaction caused more than any other reaction
Be
specific Amount
of food
for this
trial   Date
this
one
Trial Began   Date
this
one
trial
Ended    Total
Number
of
Calendar
days of trial

Row 3 Trial 1

Row 4 Trial 2

Row 5 Trial 3

Row 6 Trial 4

Row 7 Trial 5

Row 8
REPORT
THIS ROW AND
Rows 1 and 2
TOGETHER Summary

Row 9
Food trial reports including recipes like "Cake" are not conclusive: too many ingredients. "Wheaties" and similar "One ingredient" foods are best.

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	"Food Allergy Relief Sharing" a personal www site
Hula Dancer	For Your report, Send a Copy of Rows 1,2, and 8
Hawaii	The other rows are for your own records

Row 1	A	B	C	D	E	F	G	H
Row 2	Food Trial Number	Part of body affected more than any other part is: Be specific	System of body affected more than any other. Be specific	Type of reaction caused more than any other reaction Be specific	Amount of food for this trial	Date this one Trial Began	Date this one trial Ended	Total Number of Calendar days of trial
Row 3	Trial 1
Row 4	Trial 2
Row 5	Trial 3
Row 6	Trial 4
Row 7	Trial 5
Row 8 REPORT THIS ROW AND Rows 1 and 2 TOGETHER	Summary
Row 9	Food trial reports including recipes like "Cake" are not conclusive: too many ingredients. "Wheaties" and similar "One ingredient" foods are best.