Setliff Sinus Institute A Leader In Sinus Care For Over 20 Years

605-339-1872

 

Sinus History

General Information
04/25/2024
 
Complaint
When did symptoms start initially?
 
Sleep Disturbance
Energy Level
Do you have symptoms?
Do you think your symptoms are
Are your sinus/nose problems something you worry about everyday?
Do you miss work/school
Dizziness
Do you use?
Allergies
Do you think you have


Headaches/Facial Pain
Worse in the
Severity
Quality
Location
Associated symptoms
Do your symptoms worsen with exposure to
 
Which side is affected?
Mouth Breathing
Do you have problems with
Sinusitis
Relief from Antibiotics
Side effects from Antibiotics


Post-Nasal discharge/Running Nose
How much
Color
Medications
Medication Allergies
Have you had?
Sinus X-Ray
X-Ray Results
CT scans
CT Results
Septal surgery
Sinus surgery
Setliff Sinus Institute is not your ordinary sinus clinic. Because we are the most highly specialized sinus clinic in the region, focused SOLELY on sinus care