Sinus Quiz

If you expereince regular runny nose, stuffiness, or post nasal drip, chances are its time to set up an appointment. If you'd like to explore your symptoms a little more, check out the sinus quiz below. Once you get your score, we can reach out to you to set up an appointment. Just fill out the form below the quiz and hit submit and we'll reach out to you.

Rate each item below based frequency of your symptoms. *

	None	Once a Year	2-3 Times a Year	At least Once A Month	2-3 Times a Month	Almost Every Day
Need to Blow Nose
Frequent Sneezing
Runny Nose
Nasal Obstruction
Loss of Smell
Loss of Taste
Cough
Post Nasal Drip
Thick Nasal Discharge
Ear Fullness
Dizziness
Ear Pain/Pressure
Facial Pain
Facial Pressure
Difficulty Falling Asleep
Difficulty Staying Asleep
Feeling Tired After a Full Night's Sleep
Fatigue
Reduced Productivity
Inability to Concentrate
Restlessness

TOTAL SCORE
Name *

First Name Last Name
Email *
[email protected]
Phone Number *

Area Code Phone Number
Would you like us to contact you for a consultation? *

Yes No, thank you.
Understanding Your Results

Take note of your score above and use the key below to help understand your results. If you hit submit below a copy of your results will be emailed to you.


Score	Evaluation	Recommendations
0 to 10	No Problem	No actions needed.
11 to 40	Moderate Problem	We reccomend making an appointment to further understand your symptoms.
41 to 69	Moderate to Severe	An appointment is highly reccomended so we can properly diagnose and treat your symptoms.
70 and Up	Very Severe	An appointment is highly reccomended so we can properly diagnose and treat your symptoms.