The Jaffe Food Allergy Institute

Questions and Answers

Influenza Vaccination in Children with Egg Allergy: What You Should Know

About Your Visit

Read about steps to take before your visit to the Institute.

• Patient Questionnaire
  The questionnaire provides our physicians with vital information about your child. Your child's medical history, current habits, and activities will aid our staff in isolating environmental elements, specific foods, and/or specific food ingredients that may be determined to be allergens and in determining the severity of a reaction.
• Diet Sheet
  The 3-day diary shows specific data as to the type, amount, and occurrence of exposure to certain allergens. Your answers provide insight to our physicians about your child's everyday life through the foods he/she eats and the environment in which he/she lives.

HIPAA Forms

• Patient Access Request for Medical Information
• Patient Authorization for Release of Medical Information to Third Party

Practice Location

5 East 98th Street, 10^th Floor
New York, NY 10029

Directions and Map

Appointments

(212) 241-5548

Billing Inquiries

(212) 241-9464

Allergy-Related Web Sites

• www.aaaai.org
• www.faiusa.org
• www.foodallergy.org

Documents above marked are viewable with the free Adobe^TM Acrobat^TM Reader. If you do not have Acrobat Reader, click on the image below to download it.