What type of allergies affect you?
Grass
Dust
Pet dander
Pollen
Are you experiencing asthma symptoms?
Yes
No
What treatments have you tried?
Over-the-counter
Prescription meds
Natural remedies
None
How often do you seek medical help?
Monthly
Yearly
Rarely
What is your preferred contact method?
Email
Phone call
SMS
Would you like to schedule a consultation?
Yes
No
All set, how can we reach you?
Name
Email
Phone
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