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Nose Questionnaire

Nasal Obstruction and Septoplasty Effectiveness Scale

Please help us to better understand the impact of nasal obstruction on your quality of life by completing the following survey.

Over the past ONE month, how much of a problem were the following conditions for you?

1. Nasal congestion or stuffiness
2. Nasal blockage or obstruction
3. Trouble breathing through my nose
4. Trouble sleeping
5. Unable to get enough air through my nose during exercise or exertion
First Name
Last Name
Email
Phone
Excel ENT Surgeons

Contact

PHONE

(03) 9088 8222

Excel ENT Surgeons fax

FAX

(03) 9088 8223

CONSULTING LOCATIONS

Excel Camberwell
607–609 Riversdale Road,
Camberwell VIC 3124

Offspring Paediatrics
614 Glenferrie Road,
Hawthorn VIC 3122