Are Your Symptoms the Result of Chronic Sinusitis?

Submit this quick self-assessment quiz to help determine if the symptoms you are experiencing are those of chronic sinusitis.   A professional from our office will contact you to discuss the results of your quiz and schedule an evaluation as needed.  The answers to your quiz, as well as your contact information,- are strictly confidential.

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

None

Slight

Mild

Bad

Intense

Severe

1. Clogged nose

x

x

x

x

x

x

2. Runny nose

x

x

x

x

x

x

3. Post nasal discharge

x

x

x

x

x

x

4. Thick nasal discharge

x

x

x

x

x

x

5. Facial pain / pressure

x

x

x

x

x

x

6. Fatigue

x

x

x

x

x

x

7. Need to blow nose

x

x

x

x

x

x

8. Loss of smell or taste

x

x

x

x

x

x

9. Ear fullness

x

x

x

x

x

x

10. Difficulty falling asleep

x

x

x

x

x

x

11. Waking up at night

x

x

x

x

x

x

12. Lack of good night's sleep

x

x

x

x

x

x

13. Waking up tired

x

x

x

x

x

x

14. Reduced productivity

x

x

x

x

x

x

15. Frustrated / irritable

x

x

x

x

x

x

16. Reduced concentration

x

x

x

x

x

x

17. Embarrassed

x

x

x

x

x

x

18. Sad

x

x

x

x

x

x

19. Ear pain

x

x

x

x

x

x

20. Cough

x

x

x

x

x

x

0 points

(20 questions left)

No Problem

Your sinus symptoms have relatively minor effects on your quality of life.

First Name

Last Name

Phone

Email

Comments

Click the submit button below to share your Sinus Self-Assessment Quiz results with our office.

Thank you! Your results from the Sinus Self-Assessment have been submitted.

Someone from our office will be in touch with you soon

Oops! Something went wrong while submitting the form.

You will need to access this feature using a desktop or tablet device.