Transcription of Name: Date: DIZZINESS QUESTIONNAIRE
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Name: Date: DIZZINESS QUESTIONNAIRE
Name: date : DIZZINESS QUESTIONNAIREI. When you are "dizzy" do you experience any of the following sensations? Please read the entire list first, then circle the number of all thestatements that describe your dizzy I feel is a swimming sensation in the black out or have been unconscious for more than a few tend to fall to the tend to fall to the tend to fall tend to fall room or objects spin or turn around I feel a sensation that I am turning or spinning inside, with outside objects remaining I lose my balance when walking - Veering to the I lose my balance when walking - Veering to the I have a I feel I have vomited16.
Name: Date: DIZZINESS QUESTIONNAIRE I. When you are "dizzy" do you experience any of the following sensations? Please read the entire list first, then circle the number of …
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