Chronic Urticaria Activity Score & Symptom Tracker

Managing chronic urticaria (chronic hives) requires consistent symptom tracking and close collaboration with your allergist or immunologist. This Chronic Urticaria Activity Score & Symptom Tracker helps patients document daily symptom severity, track medication effectiveness, and monitor treatment response—all in one place.

Whether you're starting a new antihistamine regimen, undergoing omalizumab (Xolair) therapy, or working to identify triggers, this form provides the structured data your healthcare team needs to optimize your treatment plan. The daily symptom scoring follows established clinical frameworks for measuring urticaria severity, including itch intensity, number of wheals, and impact on daily activities.

Ideal for allergy and immunology practices, dermatology clinics, and patients self-managing chronic urticaria—this template captures everything from baseline symptoms and current medications to treatment response patterns and quality of life impacts. The built-in scheduling feature makes it easy to book follow-up appointments when symptoms worsen or when you're due for treatment review.

With Paperform's calculation engine, you can automatically score symptom severity over time, helping both patients and providers spot trends and make data-driven adjustments. And because the form is completely customizable, allergists can adapt scoring thresholds, add practice-specific questions, or connect submissions to their EHR via Stepper workflows for seamless documentation.

Paperform makes healthcare data collection feel human—not clinical. Build forms that patients actually want to complete, with on-brand design, conditional logic that shows only relevant questions, and secure submission handling that meets compliance standards. Trusted by healthcare providers worldwide and SOC 2 Type II compliant.