Patient Instruction and Consent Sheet for Allergy Skin Testing

Skin Test:
Skin tests are a method of testing for allergies. A test consists of introducing small amounts of the suspected substance, or allergen, into the skin and noting the development of a positive reaction (which consists of local swelling with a surrounding area of redness). The results are read 15 to 20 minutes after application of allergen.

The Skin test methods that are available for use are:

  1. Prick Method: The skin is pricked with a prong which has allergen on its surface.
  2. Intradermal Method: Injection of small amounts of allergen into the superficial layers of the skin.

  3. Multi-test Method: Multi-prong devices, covered by allergen, are held against the skin for 5-10 seconds.

Interpreting the clinical significance of skin tests requires a skillful correlation of the test results with the patient’s clinical history. Positive tests indicate the presence of antibodies and can be correlated with clinical symptoms.

  • You will be skin tested for important airborne allergens in the greater Houston area and possibly some foods. These allergens include grasses, weeds, trees, molds, dust mites, pet dander, and selected foods. The consultation generally takes 45 minutes to one hour. Prick tests will be performed on the arms or back. If needed, intradermal tests will be performed. Local reactions from skin testing usually resolve gradually over 4-6 hours. Sometimes the local reactions can last a few days. Contact us if you have questions.
  • If testing for antibodies, caines, venoms, or other biological agents is required, the same guidelines apply. Agent (s) may also be tested if requested by your physician.
  • We advise you not to use prescription or over- the- counter antihistamines for 3-4 days prior to the scheduled skin testing. These may interfere with the results of the tests. Medications to be avoided include Claritin, Clarinix, Allegra, Zyrtec, Actified, Drixoral, Dimetapp, Dristan, Ornade, Benadryl, C-phen Trinalin, Xyzal, Patanase, and Astelin/Astepro. Sometimes other medications may interfere with test results including antidepressants, medications used to treat ulcers and sleeping medications.
  • Continue other medications prescribed for any other medical conditions you have.
  • Continue asthma medications and nasal sprays such as nasal steroids

Please inform the physician of the following:

  • If you are on any heart medications such as beta blockers or any antidepressants. Please list all of your medications.
  • If you are pregnant, have a fever, have wheezing; signs or symptoms of any infection.

Skin tests will be administered at this medical clinic with a physician or his/her delegate (NP/PA) on the premises as occasional reactions may occur which would require immediate therapy. These reactions may consist of any or all of the following symptoms: itchy eyes, itchy nose, itchy throat; nasal congestion, runny nose, tightness if the throat or chest, wheezing, lightheadedness, faintness, nausea and vomiting, hives, generalized itching, and shock. The latter occurring under extreme circumstances. Please note that these reactions rarely occur but in the event a reaction would occur, trained staff is available with appropriate treatment options as well as access to a nearby emergency room.

I have read the patient information sheet on allergy skin testing and understand it. The opportunity has been provided for me to ask questions regarding the potential side effects of allergy skin testing and these questions have been answered to my satisfaction. I understand that every precaution consistent with the best medical practice will be carried out to protect me against such reactions. This consent is in affect for 5 years from date of signature.

Patient Instruction and Consent Sheet for Allergy Skin Testing

"*" indicates required fields

Patient Name*
MM slash DD slash YYYY
Guardian Name if patient is a Minor*
MM slash DD slash YYYY
Witness Name*
MM slash DD slash YYYY

Useful Links

West Houston Allergy & Asthma, Katy, TX

West Houston Allergy & Asthma, Richmond, TX