Sinus Assessment Sinus Self Assessment Quiz How much of a problem are the following symptoms for you? Fill out this questionairre and our team will be in touch. "*" indicates required fields Nasal Congestion or Stuffiness None Mild Moderate Bad Severe Nasal Blockage or Obstruction None Mild Moderate Bad Severe Trouble Breathing Through My Nose None Mild Moderate Bad Severe Trouble Sleeping None Mild Moderate Bad Severe Unable to Get Enough Air Through My Nose During Exercise or Exertion None Mild Moderate Bad Severe Facial Pressure or Pain None Mild Moderate Bad Severe Your ScoreScore Explanation 0 - 4 No Problem - No actions necessary or symptoms can be treated with over-the-counter medications. 5 - 10 Moderate Problem - An appointment with a specialist is recommended and/or prescription medication can be taken to treat symptoms. 11 - 17 Moderate to Severe - An appointment with a specialist is recommended to determine treatment options. 18 - 24 Severe - An appointment with a specialist is recommended to determine treatment. Possible surgical candidate.Request an Appointment Want to review your results with a member of our team? Fill out the information below:First Name * RequiredLast Name * RequiredPhone * RequiredEmail * Required I understand that Protected Health Information (PHI) or sensitive information should not be included in this message. Δ
