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Sinus Quiz

Consider how severe the problem is when you experience it and how frequently it happens, please rate each item below on how "bad" it is by ticking the radio button that corresponds with how you feel.

Complete the following Sinus Self-Assessment Quiz and someone from our office will contact you about your results.

Green cartoon happy face
None
Green cartoon smiling face
Slight
Yellow cartoon face
Mild
Orange cartoon sad face
Bad
Orange cartoon sad face
Intense
Red cartoon angry face
Severe
1. Clogged nose
2. Runny nose
3. Post nasal discharge
4. Thick nasal discharge
5. Facial pain / pressure
6. Fatigue
7. Need to blow nose
8. Loss of smell or taste
9. Ear fullness
10. Difficulty falling asleep
11. Waking up at night
12. Lack of good night's sleep
13. Waking up tired
14. Reduced productivity
15. Frustrated / irritable
16. Reduced concentration
17. Embarrassed
18. Sad
19. Ear pain
20. Cough
0 points
(20 questions left)
No Problem
Your sinus symptoms have relatively minor effects on your quality of life.
Thank you! Your results from the Sinus Self-Assessment have been submitted.
Someone from our office will be in touch with you soon.
Please feel free to give us a call as well, 214-438-5188
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