Get Name: Date: Next To Each Question, Circle The Number That ...

The Name: Date: Next To Each Question, Circle The Number That ... form is designed to help assess eustachian tube dysfunction symptoms effectively. This guide will walk you through the process of completing the form online, ensuring all your responses are accurately recorded.

Follow the steps to fill out your questionnaire accurately.

1. Click the ‘Get Form’ button to access the questionnaire. This will allow you to open the form in your preferred online editor.
2. Begin by entering your name in the designated field labeled 'Name:'. Ensure the spelling is accurate and clear.
3. Next, enter the current date in the field next to 'Date:'. Use the format that is most commonly accepted in your region.
4. For each question on the form, read the statement carefully. Circle the number that best describes your experience for the past month, with options ranging from 1 (no problem) to 7 (severe problem).
5. Indicate whether the symptoms occur in one ear or both by marking the appropriate option: 'Left ear only', 'Right ear only', or 'Both ears'.
6. After completing all fields, calculate your total score based on your responses. Divide the total score by 7 to determine your mean item score.
7. Once you have finished filling out the form, review your responses for accuracy. You can then save your changes, download the form, print it, or share it as needed.

Complete your Eustachian tube dysfunction questionnaire online today for effective symptom assessment.