Symptom Questions
Check all that apply.
Do you have clear nasal or ear discharge after a head injury?
Do you have a stiff neck (unable to flex your chin to your chest), fever, bad headache?
Do you have a fever of higher than 101º?
Do you have cold symptoms and a history of serious asthma attacks?
Do you have noticeable pain in your ears, face or chest?
Do you have shortness of breath or wheezing?
Are you unable to open your mouth fully?
Do you have a severe sore throat and are unable to swallow anything?
Do you have a single, swollen lymph node that has lasted for more than two weeks?
Are you bringing up brown, green, or bloody mucous from your lungs?
Do you have bloody or pus-looking nasal discharge?
Do you have painful sinuses?
Do you have eye pain with redness and discharge?
Do you a runny nose or postnasal drip?
Are you sneezing or do you have nasal congestion?
Do you have a scratchy or sore throat? [
See the throat illustration below for further information
].
Are you experiencing fatigue and weakness?
Do you have a cough?
Do you have a headache?
Do you have burning, itching, or watery eyes?
Do you have a feeling of pressure or clicking in your ear?
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