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Appointments
About Us
Our Team
FAQ’s
Ent Conditions /
Treatments Offered
Septoplasty
Functional Eudoscopic sinus surgery (FESS)
Tonsillectomy (Child)
Adenoidectomy
Hearing Restoration Surgery (Tympanoplasty)
Eardrum Perforation (Myringoplasty)
Cholesteatoma Surgery (Mastoidectomy)
Mastoid Revision (Obliteration)
Balance Problems
Swallowing Issues
Voice Problems
Skin cancer removal
Benign Paroxysmal Positional Vertigo (BPPV)
Grommet insertion
Doctors
Patients
Locations
Contact
Appointments:
0407 924 224
Request Appointment Online
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Appointments
0407 924 224
Request Appointment Online
Appointments
About Us
Our Team
FAQ’s
Ent Conditions /
Treatments Offered
Septoplasty
Functional Eudoscopic sinus surgery (FESS)
Tonsillectomy (Child)
Adenoidectomy
Hearing Restoration Surgery (Tympanoplasty)
Eardrum Perforation (Myringoplasty)
Cholesteatoma Surgery (Mastoidectomy)
Mastoid Revision (Obliteration)
Balance Problems
Swallowing Issues
Voice Problems
Skin cancer removal
Benign Paroxysmal Positional Vertigo (BPPV)
Grommet insertion
Doctors
Patients
Locations
Contact
Sino Nasal Outcome Test Form
SINO NASAL OUTCOME TEST (SNOT-22) SCORE
FullName:
Date:
Email:
DOB:
Considering 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 circling the number that corresponds with how you feel.
01. Need to blow nose:
None
Mild
Moderate
Slight
Bad
Severe
02. Sneezing:
None
Mild
Moderate
Slight
Bad
Severe
03. Runny Nose:
None
Mild
Moderate
Slight
Bad
Severe
04. Nasal Obstruction:
None
Mild
Moderate
Slight
Bad
Severe
05. Loss of smell or taste:
None
Mild
Moderate
Slight
Bad
Severe
06. Cough:
None
Mild
Moderate
Slight
Bad
Severe
07. Post-nasal discharge:
None
Mild
Moderate
Slight
Bad
Severe
08. Thick nasal discharge:
None
Mild
Moderate
Slight
Bad
Severe
09. Ear fullness:
None
Mild
Moderate
Slight
Bad
Severe
10. Dizziness:
None
Mild
Moderate
Slight
Bad
Severe
11. Ear pain:
None
Mild
Moderate
Slight
Bad
Severe
12. Facial pain/pressure:
None
Mild
Moderate
Slight
Bad
Severe
13. Difficulty falling asleep:
None
Mild
Moderate
Slight
Bad
Severe
14. Wake up at night:
None
Mild
Moderate
Slight
Bad
Severe
15. Lack of a good night’s sleep:
None
Mild
Moderate
Slight
Bad
Severe
16. Wake up tired:
None
Mild
Moderate
Slight
Bad
Severe
17. Fatigue:
None
Mild
Moderate
Slight
Bad
Severe
18. Reduced productivity:
None
Mild
Moderate
Slight
Bad
Severe
19. Reduced concentration:
None
Mild
Moderate
Slight
Bad
Severe
20. Frustrated/restless/irritable:
None
Mild
Moderate
Slight
Bad
Severe
21. Sad:
None
Mild
Moderate
Slight
Bad
Severe
22. Embarrassed:
None
Mild
Moderate
Slight
Bad
Severe
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