- Do you have occupational exposure to latex, especially powdered gloves? Y/N
- Do you have spina bifida, genitourinary abnormalities, or cerebral palsy?Y/N
- Do you suffer from asthma, eczema of food allergies (particularly bananas, kiwi, chestnuts or avocado)? Y/N
- Do you have a history of multiple surgeries? Y/N Have you experienced a rash or dermatitis on contact with latex or rubber products? Y/N
- Have you experienced rash/wheezing/swelling/itching associated with dental exams, balloons, condoms, or rectal/vaginal exams? Y/N
If you answered yes to any part of question A and either B or C, you should notify your physician that Latex Precautions should be taken.