Sinus Infection Survey

Sinus Infection

There are only a few steps to get started.

    Choose your Location

    What is your date of birth?

    Do you experience face pain, problems breathing from the nose, and nasal discharge?

    STOP HERE if you do not have sinus infection symptoms. We only evaluate for sinus infections.

    Do you experience any of the following symptoms?

    When did you start getting sick?

    Do you have thick, yellow-green nasal discharge?

    For how many days?

    With this illness, do you have difficulty breathing through your nose?

    Do over-the-counter decongestants make you feel better?

    Do you….?

    Have you had the following?

    Do you have any of the following symptoms?

    Are you allergic to any medicines? Milk protein? Aspirin, NSAIDs, or phenylalanine?

    Please list your drug allergies and what happens when you use that drug.

    Do you take other medication(s) or have any other medical conditions?

    Include vitamins, herbs, and over-the-counter products, like pain relievers and sleep aids and WHY you are taking them.

    In order for us to provide you with the best care, please let us know what medications you take and what conditions you have.

    Do you have any of these conditions?

    Anything else you would like us to know?

    How would you like to pay?

    upload emirates insurance details (if available)

    Upload a Photo of your Emirates ID
    Upload Front

    Upload Back

    Billing and delivery details

    Google Map: (Please Share your Google Map Link)
    Delivery Location
    Street Name/No:
    Address Details:

    Personal Details

    First Name: Last Name:
    Mobile Number: E-mail:

    Confirm Request and Agree to Terms