Patch Testing Questionnaire
What a patch testing questionnaire asks before contact allergy testing, with sample questions for practice staff.
The patch testing questionnaire on this page covers the rash, past allergies, and what touches the skin at home, in hobbies, and at work. UNC Dermatology calls its version a 3-page allergy history form.
Patch testing questionnaire, handled by the AI Doctor avatar
AI Doctor, a real-time AI healthcare assistant avatar, asks the questions on a patch testing questionnaire in the patient's own language, strictly following the practice's instructions.
- Intake before the visit. Patients answer online before they arrive, or at a kiosk when they check in.
- Answers ready for the clinician. Clinicians see what the patient said before the visit starts.
- Less workload at the front desk. Staff spend less time handing out forms and entering answers by hand.
- Key details at a glance. The care team sees what matters up front and decides who needs attention first.
The form becomes a natural conversation: patients answer by talking, in their own words. AI Doctor is an information and patient-assistance interface. It collects answers for the care team to review. It doesn't diagnose, triage, or give treatment advice.
Sample patch testing questionnaire questions
Typical questions, written out so you can see the level of detail. Every practice words its own form differently.
- When did the rash start?Rash history
- Does it improve on weekends or vacations?Rash history
- Did you have eczema as a child?Allergies
- Are you allergic to nickel, latex, or fragrance?Allergies
- Do you have pets at home?Home
- Which detergent do you use for laundry?Home
- Which sports or hobbies do you do?Hobbies
- What materials do you handle in your hobbies?Hobbies
- Which lotions or creams do you use?Personal care
- Do you color your hair?Personal care
- Which materials do you handle at work?Work
- Do coworkers have the same problem?Work
These are examples to read, not a form to fill in.
Patch testing questionnaire: FAQ
What does a patch testing questionnaire ask?
The sample questions on this page are based on the patch test intake form from Weill Cornell Medicine's dermatology practice. This page groups them into six areas: rash history, allergies, home, hobbies, personal care, and work.
Who fills in a patch testing questionnaire, and when?
The patient, before the first testing visit. UNC Dermatology asks patients to bring the completed form to the visit, and OHSU sends its product questionnaire before the visit.
Why does it ask about products, hobbies, and work?
UNC Dermatology's pre-visit instructions say the interview about exposures, together with the products patients bring, forms the basis for its patch testing.
Does it ask about medicines?
Yes. UNC Dermatology's instructions name oral and injected cortisone as medicines that can interfere with patch testing. The practice's team decides what a patient should do about any medicine.
Is there a patch testing questionnaire template?
Weill Cornell and UNC Dermatology each use their own version. The sample questions on this page show a typical set.
What happens after the patient answers?
The practice's team reviews the answers before the testing visit. AI Doctor only collects them and does not choose which substances to test.
Does AI Doctor give medical advice?
No. It collects information for the care team. It doesn't diagnose, triage, or recommend treatment.
Can patient answers stay on our own servers?
Yes. RAVATAR offers on-prem deployment: the platform can run inside your own perimeter, so patient answers stay there. RAVATAR complies with GDPR and the EU AI Act.
Set up your AI Doctor in Genesis AI Avatar Studio
Genesis AI Avatar Studio is where you set up, test, and publish AI avatars for your website, mobile app, or Holobox. No coding or technical skills needed.
- 01Choose the AI Doctor avatar.
- 02Add your practice's FAQs and visit information.
- 03Talk to it, then publish it.
