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SNOT-20 (Sinus) Survey

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 selecting the button that corresponds with how you feel.

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Need to blow nose

Sneezing

Runny nose

Cough

Post-nasal discharge

Thick nasal discharge

Ear fullness

Dizziness

Ear pain

Facial pain / pressure

Difficulty falling asleep

Wake up at night

Lack of sleep

Wake up tired

Fatigue

Reduced productivity

Reduced concentration

Frustrated / restless / irritable

Sad

Embarrassed

You received a score of 0

No problem to mild problem: You are not experiencing common signs of sinus issues. However, if you are experiencing other symptoms not listed here, please contact our office for a consultation.

Moderate problem: An appointment with a specialist or your Primary Care Physician is recommended and/or prescription medicine can be taken to treat symptoms.

Moderate to severe: An appointment with a specialist or your Primary Care Physician is recommended and/or prescription medicine can be taken to treat symptoms.

Severe to “as bad as it can be”: An appointment with a specialist is recommended, treatment to be determined by the doctor.