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Skin Test Recording Form: Red Oak & Red River Birch

This form is a standardized Skin Test Recording Sheet used to document patient results for allergy testing specifically related to Red Oak and Red River Birch antigens. Nurses use this resource during allergy scratch or prick testing to record wheal scores, reaction sizes, and patient information. It ensures accurate tracking of test outcomes, provides structured spaces for physician review, and supports clinical decision-making about whether a patient is a candidate for immunotherapy. Proper documentation on this form helps maintain compliance, facilitates billing and insurance submissions, and ensures continuity of care for patients undergoing allergy diagnostics.

Frequently Asked Questions Answered in this PDF

  • What is the purpose of this form?

Answered at: Form Header – Skin Test Recording Form
This form is used to record patient results from allergy testing for Red Oak and Red River Birch antigens, ensuring accurate documentation for clinical and insurance purposes.

  • What patient details need to be recorded?

Answered at: Patient Information Section
Nurses must document the patient’s name, date of birth, phone number, and relevant appointment or medication history before starting the test.

  • How do I record allergy test results?

Answered at: Panel Recording Grid
Each antigen panel has a space to record the wheal score (size of the reaction) and notes for clinical interpretation.

  • Why are histamine (+) and glycerosaline (–) controls included?

Answered at: Documentation Review Section
Histamine ensures the test is responsive, while glycerosaline is the negative control. Comparing allergen reactions to these helps confirm whether results are valid.

  • How should borderline results be interpreted?

Answered at: Notes & Measuring Guidelines
If an allergen response measures 3–4mm but is close to the negative control, it is considered borderline positive. Clinical history should be reviewed before recommending treatment.

  • What does the physician need to confirm on this form?

Answered at: Physician’s Signature Section
The physician must review the test results, confirm whether subcutaneous immunotherapy (SCIT) is recommended, and sign off on the form.

  • What should the patient do after the test?

Answered at: Patient Signature Section
The patient signs the form acknowledging the test was completed and whether they agree to proceed with immunotherapy (AIT).

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