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This field is for validation purposes and should be left unchanged.
1. Rate your nasal congestion or stuffiness
(Required)
0 - NO congestion or stuffiness
1 - MILD congestion or stuffiness
2 - MODERATE congestion or stuffiness
3 - FAIRLY BAD congestion or stuffiness
4 - SEVERE congestion or stuffiness
2. Rate your nasal blockage or obstruction
(Required)
0 - NO blockage or obstruction
1 - MILD blockage or obstruction
2 - MODERATE blockage or obstruction
3 - FAIRLY BAD blockage or obstruction
4 - SEVERE blockage or obstruction
3. Trouble breathing through your nose?
(Required)
0 - NO trouble breathing
1 - MILD trouble breathing
2 - MODERATE trouble breathing
3 - FAIRLY BAD trouble breathing
4 - SEVERE trouble breathing
4. Trouble sleeping?
(Required)
0 - NO problem sleeping
1 - MILD problem sleeping
2 - MODERATE problem sleeping
3 - FAIRLY BAD problem sleeping
4 - SEVERE problem sleeping
5. Rate your ability to get enough air through your nose during exercise or exertion?
(Required)
0 - NO problem getting enough air
1 - MILD problem getting enough air
2 - MODERATE problem getting enough air
3 - FAIRLY BAD problem getting enough air
4 - SEVERE problem getting enough air
You May Be A Candidate
Your responses indicate Moderate to Severe chronic rhinitis.
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