Anita Carmen Choy, MD

Welcome to the new online home of Allergist Anita Carmen Choy, MD. Currently serving adults and children suffering from allergies and asthma, Dr. Choy is a Board Certified Allergist, providing comprehensive medical care for adult and children in the Silicon Valley since 1995.

Sino-Nasal Outcome Form 2024

Welch Pasteur Allergy Medical Group, Inc

Anita Carmen Choy, MD | Hailen Mak, MD
211 Quarry Road, Suite 106 MC 5996,
Palo Alto, CA 94304
Ph: 650.322.3847  |  Fax: 650.322.3249

Patient Sino-Nasal Outcome Test

Below you will find a list of symptoms and social/emotional consequences of your rhinosinusitis. We would like to know more about these problems and would appreciate your Answering the following questions to the best of your ability. There are no right or wrong answers, and only you can provide us with this information. Thank you for your participation. Do not hesitate to ask for assistance if necessary.

Rate Your Symptoms in the Past Two Weeks

Considering how severe the problem is when you experience it and how often it happens, please rate each item below on how "bad" it is by selecting the number that corresponds with how you feel using the provided.

1. Need to blow nose:
2. Nasal Blockage
3. Sneezing
4. Runny Nose
5. Cough
6. Post-nasal Discharge
7. Thick Nasal Dischage
8. Ear Fullness
9. Dizziness
10. Ear Pain
11. Facial Pain or Pressure
12. Decreased Sense of Smell or Taste
13. Difficulty Falling Asleep
14. Waking Up at Night
15. Lack of Good Night's Sleep
16. Waking Up Tired
17. Fatigue
18. Reduced Productivity
19. Reduced Concentration
20. Frustrated/Restless/Irritable
21. Sad
22 Embarrassed
Please choose the 5 most important issues to you, from the problems above.