Table 1.
Example Food challenge score sheet
| Minutes after start | Portion | Time (hr) | Observations/Symptoms |
|---|---|---|---|
| Part 1 | |||
| T= 0 | 1 | 10.30 | At 10:35 patient reports mild abdominal pain, the pain disappeared spontaneously within 10 minutes. |
| T=15 | 2 | 10.45 | - |
| T=30 | 3 | 11.00 | Patient does not like the food and eats very slowly. |
| T=45 | 4 | 11.15 | - |
| T=60 | 5 | 11.30 | - |
| T=75 | 6 | 11.45 | - |
| T=90 | 7 | 12.00 | At 12:05 mild sneezing (2 times), no other symptoms. |
| T=105 | 8 | 12.15 | - |
| Part 2 | |||
| T=120 | 9 | 12.30 | - |
| T=150 | 10 | 13.00 | At 13.15 Severe vomiting (1 time). No other symptoms. |
| T=180 | 11 | NA | - |
| T=210 | 12 | NA | - |
| T =240 | 13 | NA | - |
| Other comments: Patient is a very difficult eater, and did not like the food during challenge. | |||