1 OF 5 - Sinus Pain & Pressure

Help us understand the severity of your allergies

How many days ago did you begin experiencing bothersome sinus pressure symptoms?

How frequently are you experiencing symptoms?



Which of the following symptoms are currently bothering you?

Do any of these symptoms apply to you?

Are you experiencing any additional symptoms?

Did your environment change prior to the onset of your symptoms? If so, briefly describe the change (for example, moving to a new home) and when it occurred.

Your sinus history

How many sinus infections have you been treated for in the last year?

Have you ever taken oral steroids, such as Medrol or prednisone?

Have you ever had sinus surgery? If so, please list the dates and procedures that were performed.

Have you been told you have nasal/sinus polyps?

If you've taken medications in the past, were they effective? Please list the medication names and how long you used them (or if you are still using them). Please include any antibiotics, nasal sprays, or other oral pills (e.g. Claritin®, Zyrtec®, Allegra®). If you haven't tried any treatments, you can leave this question blank.

Do you have any environmental allergies (hay fever, seasonal allergies, dust, etc.)?

Have you ever undergone allergy testing?

Have you ever taken allergy shots?

Let's find the right treatment for you

Do you smoke?

Are you allergic or sensitive to aspirin?

Is there anything else related to treatment that you'd like to ask or discuss with your medical provider?

Do you have a preferred treatment?

Would you like to share anything else with your provider through an upload?

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