Diagnostics Inquiry

Practice Name*

Provider Name(s)*

Primary Contact*

Email*

Practice Location*

State

Phone*

Current Allergy Testing Methods*

If other skin allergy testing method, what method do you use?

If you offer in vitro testing, what lab do you use?

If currently offering immunotherapy, indicate which type:

If you use another protocol, what protocol are you using?

What other immunotherapy do you offer?

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