Thank you!

[ here you'll be redirected to the results/suggestion ]go to "questionnaire results" to see page layout

Hello there!

What's your name?
____________________

Hi! Nice to meet you James

Hope you are having a lovely day!

Do you have parents or relatives suffering from rhinitis / asthma?

YES | NO

Do you suffer from itchy, red or watery eyes during the year?

YES | NO

Do you experience runny nose/nasal obstruction or nasal itching for many consecutive days?

YES | NO

Your nasal/ocular complaints do usually start or worsen during the spring?

YES | NO

Have you ever heard wheezing breath?

YES | NO

Did you ever had cough or shortness of breath, even during exercise?

YES | NO

Do you have nocturnal awakenings due to shortness of breath or cough?

YES | NO

Do you use nasal sprays frequently?

YES | NO

Do you feel that your nasal symptoms worsen in dusty environments?

YES | NO

Last question! We're glad to have met you. How did you hear about us?

Friend
Social Media
Blog
Mail
Other

Thank you!

[ here you'll be redirected to the results/suggestion ]go to "questionnaire results" to see page layout

Hello there!

What's your name?
____________________

Hi! Nice to meet you James

Hope you are having a lovely day!

Do you have parents or relatives suffering from rhinitis / asthma?

YES | NO

Do you suffer from itchy, red or watery eyes during the year?

YES | NO

Do you experience runny nose/nasal obstruction or nasal itching for many consecutive days?

YES | NO

Your nasal/ocular complaints do usually start or worsen during the spring?

YES | NO

Have you ever heard wheezing breath?

YES | NO

Did you ever had cough or shortness of breath, even during exercise?

YES | NO

Do you have nocturnal awakenings due to shortness of breath or cough?

YES | NO

Do you use nasal sprays frequently?

YES | NO

Do you feel that your nasal symptoms worsen in dusty environments?

YES | NO

Last question! We're glad to have met you. How did you hear about us?

Friend
Social Media
Blog
Mail
Other

Thank you!

[ here you'll be redirected to the results/suggestion ]go to "questionnaire results" to see page layout