TOTAL NASAL SYMPTOM SCORE PLEASE ANSWER ALL QUESTIONS TO ...

1 TOTAL NASAL SYMPTOM SCOREPLEASE ANSWER ALL QUESTIONS TO THE BEST OF YOUR information will assist us in understanding and treating your PLEASE rate how your NASAL congestionhas been over the past:12 hoursLast 2 weeksNone00 Mild ( SYMPTOM clearly present but easily tolerated)11 Moderate ( SYMPTOM bothersome but tolerable)22 Severe ( SYMPTOM difficult to tolerate interferes with activities)332. PLEASE rate how your runny nosehas been over the past:12 hoursLast 2 weeksNone00 Mild ( SYMPTOM clearly present but easily tolerated)11 Moderate ( SYMPTOM bothersome but tolerable)22 Severe ( SYMPTOM difficult to tolerate interferes with activities)333. PLEASE rate how your NASAL itchinghas been over the past:12 hoursLast 2 weeksNone00 Mild ( SYMPTOM clearly present but easily tolerated)11 Moderate ( SYMPTOM bothersome but tolerable)22 Severe ( SYMPTOM difficult to tolerate interferes with activities)334. PLEASE rate how your sneezinghas been over the past:12 hoursLast 2 weeksNone00 Mild ( SYMPTOM clearly present but easily tolerated)11 Moderate ( SYMPTOM bothersome but tolerable)22 Severe ( SYMPTOM difficult to tolerate interfereswith activities)335.

2 PLEASE rate how difficult sleephas been with NASAL symptoms:Last nightLast 2 weeksNone00 Mild ( SYMPTOM clearly present but easily tolerated)11 Moderate ( SYMPTOM bothersome but tolerable)22 Severe ( SYMPTOM difficult to tolerate interferes with activities)33 TOTAL SCORE : _____ / _____