Help Advance Food Allergy Research!
This study is for children and adults of all ages with any (or multiple) life-threatening food allergy. Please answer the survey for one person only. If you have multiple children with food allergies, answer the survey multiple times - once for each child.
**If you (or your child) are currently in any type of food allergy treatment program, please answer the survey questions in relation to the food allergies present BEFORE treatment.**

This survey is completely anonymous. Birth month and year is asked to help us determine the ages of participants of the study. You may put only the year if you prefer. Birth location and residence location is asked to help us determine geographical patterns. If you prefer, you may write only the country.

No personal or contact information is asked for or required to participate. If you wish to receive the final data and results of the study, you may leave your email at the end of the survey. Leaving your email is completely optional and not required to participate.

By participating in the study yourself or on behalf of your child, you consent to the primary investigator of this study, Natalie Rhone, to include your data in the analysis. The research study is being conducted by a group of premedical students through the allergy organization No Nuts 4 Me.

You certify that all information provided is accurate to the best of your knowledge and is not falsified or exaggerated in any manner.
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Month and year of birth *
City/state/country of birth *
City/state/country of residence *
Do you experience an itchy mouth/throat during anaphylaxis? *
Please check each symptom you have experienced during any of your past allergic reactions. *
Required
Please check all the boxes for foods that you have experienced any of the above symptoms for. Do NOT include foods that cause ONLY itchy mouth/throat. *
Required
If you checked YES for TREE NUTS, please check the ones that have caused the above symptoms. (If no, skip to the next question).
If you checked YES for SEEDS, please check the ones that have caused the above symptoms. (If no, skip to the next question).
If you checked YES for FRUITS, please check the ones that have caused the above symptoms. (If no, skip to the next question).
If you checked YES for PITTED FRUITS, please check the ones that have caused the above symptoms. (If no, skip to the next question).
If you checked YES for VEGETABLES, please check the ones that have caused the above symptoms. (If no, skip to the next question). **side note: yes we know some of these are scientifically considered fruits.
If you checked YES for HERBS OR SPICES, please check the ones that have caused the above symptoms. (If no, skip to the next question).
If you checked YES for LEGUMES (other than peanut/soy), please check the ones that have caused the above symptoms. (If no, skip to the next question).
If you checked YES for MEAT, please check the ones that have caused the above symptoms. (If no, skip to the next question).
If you checked YES for GRAINS (other than wheat), please check the ones that have caused the above symptoms. (If no, skip to the next question).
If you checked YES for SOY, please check the ones that have caused the above symptoms. (If no, skip to the next question).
At what age was the first allergic reaction? *
How many reactions have you had where epinephrine was used? *
Please check all of the following medications that are on your action plan.
Do you have environmental allergies? *
Is there a food that you are allergic to that you did not find on any of our lists? Please list any foods that we missed.
If you would like to receive the results of this study, please leave your email address below.
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