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Sinuplasty
Eustachian tube
dysfunction
Gillum
Esthetics
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Institute
Information
Balloon
Sinuplasty
Eustachian tube
dysfunction
Gillum
Esthetics
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Do you experience any of the following symptoms?
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Facial Pain
Facial Pressure
Recurrent Sinus Infections
Sinus Headaches
None of the Above
Check all that apply.
Has a doctor prescribed sinus medication for you to address your condition(s)?
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Yes
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In the past year, how many weeks have you taken sinus medication for your condition?
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Does not apply
Less than 4 Weeks
4 - 5 Weeks
6 - 8 Weeks
9 - 12 Weeks
More than 12 Weeks
Has your doctor referred you to an Ear, Nose & Throat (ENT) specialist?
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Yes
No
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SNOT-22
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(765) 651-4278
801 W Gardner Dr.,
Marion,
IN
46952
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