Self-Assessment Checklist

To provide you with the appropriate nasal allergy treatment, your doctor needs your help. Accurate, up-to-date information about your nasal allergy symptoms and medical history can help you and your doctor find out the following:

• Whether your symptoms are caused by nasal allergies or some other medical condition
• Whether your symptoms are allergic or nonallergic in nature
• Whether you suffer from seasonal or year-round nasal allergies
• What specific allergens trigger your nasal allergy symptoms
• What you can do to reduce exposure to your nasal allergy triggers
• What type of treatment may provide the best results in relieving nasal allergy symptoms

Use this Self-Assessment Checklist to get a better understanding of your nasal allergies. You can print it out and share it with your doctor. You can also use the Self-Assessment Checklist for your child, to help his or her doctor understand his or her symptoms.

Following are 3 different checklists. The one you select should most closely reflect where you are along the nasal allergy treatment path. Choose the one below that sounds most like you:

I'm trying to find the right treatment for my nasal allergies.

I'm taking RHINOCORT AQUA (or it has been prescribed for me), and I'd like to get the most out of it.

I'm not completely satisfied with my nasal allergy treatment and would like to talk to my doctor about other treatment options.