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Sore throat/strep throat/pharyngitis/tonsillitis QUESTIONNAIRE **PLEASE USE BLUE OR BLACK INK ONLY** Patients name: DOB: DATE: 1. How frequently did you experience an episode of tonsillitis/pharyngitis/strep.

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How to use or fill out the Tonsils & Dysphagia Questionnaire online

Filling out the Tonsils & Dysphagia Questionnaire is an essential step in assessing your throat-related health issues. This guide will help you navigate the form easily and ensure that all necessary information is accurately provided online.

Follow the steps to complete the questionnaire online.

  1. Press the ‘Get Form’ button to access the Tonsils & Dysphagia Questionnaire and open it in your preferred online editor.
  2. Begin by entering your personal information at the top of the form. Complete the patient’s name and date of birth (DOB) fields, making sure each entry is accurate.
  3. Next, review the first section regarding episodes of tonsillitis or pharyngitis experienced. Indicate how frequently these episodes occurred in the past year and in previous years by selecting the appropriate checkbox.
  4. For each episode you identified, indicate whether you saw a physician by checking 'Yes' or 'No' in the specified field.
  5. Continue to the next question, where you will state whether throat cultures were obtained at the time of diagnosis.
  6. Indicate how many days of work or school you missed due to each episode. Choose the correct option based on your experience.
  7. For treatment, specify if you were treated with antibiotics for your condition when diagnosed. Indicate 'Yes' or 'No' for each episode as well.
  8. Record if you experienced fever in relation to your condition by checking 'Yes' or 'No'.
  9. Answer the questions about ‘bad breath’ (halitosis) and swallowing problems by marking the appropriate box.
  10. Move to the second part of the form regarding swallowing issues, where you will find additional questions. Answer each with 'Yes' or 'No' as applicable.
  11. Once all fields are filled out, review your entries for accuracy and completeness.
  12. Finally, save changes, download, print, or share the completed questionnaire according to your needs.

Complete your Tonsils & Dysphagia Questionnaire online today for a thorough assessment of your throat health.

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When the tonsils are enlarged, they can cause a variety of symptoms. Sometimes they cause no problems at all. In other cases, they can cause or contribute to snoring and sleep problems.

Probably the most common cause of dysphagia is a sore throat related to a respiratory infection or tonsillitis, which is usually associated with other symptoms that only last a few days when treated. When dysphagia continues or gets worse with time, it's cause for concern.

Enlarged tonsils and adenoids in children may result from infections but may be normal. Enlargement usually causes no symptoms but can occasionally cause difficulty breathing or swallowing and sometimes recurring ear or sinus infections or obstructive sleep apnea.

Enlarged tonsils: Enlarged tonsils can lead to trouble swallowing or to obstructive sleep apnea, a condition that involves difficulty breathing during sleep. In these cases, taking the tonsils out can help treat the condition by removing the obstruction.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232