(770) 427-0368
Atlanta - Canton - Cartersville - Marietta - Woodstock
Balloon Sinuplasty
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(770) 427-0368
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Do you experience any of the following symptoms?
*
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)?
*
Yes
No
In the past year, how many weeks have you taken sinus medication for your condition?
*
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?
*
Yes
No
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