Hay Fever Injection Form

Can you confirm that you have tried all the Over The Counter Hay Fever medicines available for at least 28 days and they have not been effective? *

Have you tried Fexofenadine 120mg? Available for sale at the pharmacy. *

Are you Diabetic? *

Do you suffer from stomach ulcers? *

Do you currently have a high temperature? *

Have you ever received a Kenalog injection? *

Have you ever had an allergic reaction to Kenalog injection or other steroids in the past? *

Are you currently taking any non steroidal anti-inflammatory (NSAID) medication like Ibuprofen or Naproxen? *

Do you suffer from any of the following conditions? - Recent bowel surgery - Infection or inflammation in the veins of your legs - Mental health disorders - Epilepsy - Cancer - Osteoporosis - Myasthenia Gravis - Uncontrolled high blood pressure - Heart failure - Visual disturbances, loss of vision, eye inflammation, viral retinitis - Oral anti-retrovirals or oral antifungals *