Find Out if You Qualify

Do you experience any of the following more than 2 times a year?

Pressure or pain over the sinuses
Headaches in the front of the head
Sinus congestion
Recurrent sinus infections
Yes No

Do any of the symptoms you selected last more than 2 weeks at a time?

Yes No

Do these symptoms have any of the following affects on your life?

Decreased activity (work or play)
Difficulty concentrating
Increased frustration
Increased stress
Yes No

Have you been prescribed medication for a sinus infection or sinus symptoms more than 2 times a year?

Yes No

Have you been referred to an Ear, Nose and Throat Specialist to evaluate your sinuses?

Yes No

Have you been on more than one type of medication for your sinuses?

Yes No

Are you tired of trying several different medications for your sinus symptoms?

Yes No Not Applicable

You may benefit from a Balloon Sinuplasty Procedure. Complete the following for a consultation with one of our ENT Specialists!

Based on some of your answers you may not be a candidate for Balloon Sinuplasty at this time. However, please complete the following for a consultation with one of our ENT Specialists!

We encourage you to schedule an appointment with our specialists to discuss your symptoms and see what treatment options would benefit you. We are here to help in any way we can. We look forward to hearing from you soon!

You may benefit from a Balloon Sinuplasty Procedure. Complete the following for a consultation with one of our ENT Specialists!

Based on some of your answers you may not be a candidate for Balloon Sinuplasty at this time. However, please complete the following for a consultation with one of our ENT Specialists!

We encourage you to schedule an appointment with our specialists to discuss your symptoms and see what treatment options would benefit you. We are here to help in any way we can. We look forward to hearing from you soon!

By providing my phone number, I agree to receive text messages from Relief Sinus Institute regarding my results and any other related messages.*