ISAC Test | London Allergy & Immunology Centre

Section 5 - Food Allergies
Do you have any food allergies?
- Yes
- No
Please give details of any food allergies/sensitivity and briefly describe the reaction. Please state if the reaction is immediate or delayed:
If any, please give details of foods you avoid and why:

Other details
If you have any further information to add on any aspect of your condition, please do so below.

I give permission for a blood sample to be collected from a finger-prick or a vein, for the purpose of a specific IgE test. This is a required field.*
- Agreed
I give permission for a copy of the results to be sent to my GP. This is a required field.
- Agreed
- Disagree
GP's Address if selecting Agreed from above
Street Address Address Line 2 City Country Post Code Country
I give consent for the use of anonymised information from this questionnaire and test results for teaching, audit and research purposes. This is a required field.*
- Agreed
Payment and sample collection*
- Agree to have allergy test done
Once you have paid the fee via our secure Worldpay system, your testing kit will be sent out to your home address. You will get an e-mail with a link to full video instructions on how to collect the sample from a finger prick. (if you are not comfortable with collecting your own sample please visit our London Laboratory (Oxford Circus) with the form, or make your own arrangements locally with a healthcare professional capable of taking blood sample). For children blood needs to be collected only by a medical professional. (Please take the lab form to our London laboratory (Oxford Circus), or make your own arrangements with a healthcare professional capable of taking the sample from children locally and post the blood sample in the prepaid envelope). The sample tube has to be labelled with the patient's name and date of birth.
ISAC Test Payment*
Price: £ 399.00

ISAC Symptom Questionnaire