PRE-CHECK
SYMPTOMS
RESULTS
Results
These are the results of the Pre-CoMiSS™ test. Print or send by email these results, which may help your pediatric doctor to support a diagnosis of cow’s milk allergy.
Pre-Check
Questions
Answers
How old is your baby now?
Less than 6 months
What milk is your baby currently taking?
Cow’s milk-based formula
Has your baby started eating solid foods?
Yes
Does your baby have any of the following? Blood in poo/stools, obvious infection/fever, poor growth
No
Has your baby had an immediate reaction on feeding e.g., swollen lips/eyelids and immediate rash?
No
Is your baby unsettled and experiencing fussiness most days?
Yes
Overall, has your family’s quality of life been impacted by your baby’s symptoms?
5 (significantly affected)
Thank you for completing this form, your data will not be automatically saved. Please make sure to download the symptom summary for your consultation with your healthcare professional.
Symptoms
Summary
Answers
Crying
3 to 4 hours/day
Spitting-up
More than 5 episodes of around half the feed
Poo
Type 5 and 6
Skin
- Yes ( )
- Not Difficult to sleep
Respiratory
Thank you for completing this form, your data will not be automatically saved. Please make sure to download the symptom summary for your consultation with your healthcare professional.
