Take The Test Step 1 Step 2 Step 3 Step 4 Step 5 Do you experience any of the following symptoms? Do you experience any of the following symptoms? Facial Pain Facial Pressure Recurrent Sinus Infections Sinus Headaches None of the Above Has a doctor prescribed sinus medication for you to address your condition(s)? 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? 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? Has your doctor referred you to an Ear, Nose & Throat (ENT) specialist? Yes No Almost There! Name Phone Email Comments or Questions I understand and agree to not share any personal health information on this non secure web form I understand and agree to not share any personal health information on this non secure web form. * SHOW SUMMARY Some required Fields are emptyPlease check the highlighted fields. Submit Previous Step Next Step Get In Touch With UsSend Us A Message Take The Sinus QuizIf you qualify for BSP IN-OFFICE PROCEDURES Balloon Sinuplasty REQUEST CONTACT Your Name* Phone Number* Email Address* Get More Information
