Sinus Institute – Sinus Quiz

First Name *

Last Name *

Email *

Phone

Sinus Symptoms Experienced *
Discolored Nasal DrainageNasal Congestion or BlockageFacial Pain/Pressure/FullnessDecreased Sense of Smell or Taste
How long have you had these symptoms?
—Please choose an option—Less than 3 monthsMore than 3 monthsNone of the above
Have you been treated for sinusitis?
—Please choose an option—YesNo
Which of the following treatments have you tried?
AntibioticsNasal or Oral SteroidsDecongestants
Other Treatment

Where Did You Hear of Us?