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Critical Information for Sufferers of Chronic Sinusitis, and Mold Related Illness

Welcome friend of Sinusitis Wellness

Your Free Personal Evaluation

Immune Response & Mold Disease Evaluation

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Welcome friend of

Know The Cause

Immune Response & Mold Disease Evaluation

Section 1: Sinus History

1. How many sinus infections have you had in the past year?
 
 
 
 
 
 
2. How many times a month do you have sinus headaches (not migraines)?
 
 
 
 
 
 
3. How many times have you taken antibiotics in the last year?
 
 
 
 
 
 
4. Have you had aspirin allergy?
 
 
5. Do you have loss of smell?
 
 
6. Do you have nasal airway obstruction?
 
 
 
 
 
7. Do you have postnasal drip?
 
 
 
 
 
8. Do you have allergies (non-food)?
 
 
9. How many sinus surgeries have you had?

Section 2: Your Environment

10. Has the furnace or air conditioner location in your home ever been damp?
 
 
11. Is the heater or air conditioner located in a dirt crawl space?
 
 
12. Is your crawl space damp?
 
 
13. Is the heater located in the attic with blown-in insulation?
 
 
14. Do you have a humidifier in the central furnace?
 
 
15. Have you had a leak or flood anywhere in your home?
 
 
16. Do you ever notice a musty smell in the house?
 
 
17. Have you noticed any mold in the house (other than the bathroom shower/tub)?
 
 
18. Do you feel better (physically) away from home
 
 
19. Do you feel better (physically) away from the office?
 
 
20. Do you or your co-workers feel bad at the office?
 
 
21. Do you feel better if you go to the beach or other clean air space?
 
 
22. Do you have pets in the home?
 
 
23. Do you sleep with your pets?
 
 

Section 3: Additional History

24. Do you experience fatigue or tiredness regularly?
Rate your level of fatigue:  0=can walk 5 miles        10=can’t get out of bed
25. Do you have any of the following? (Check all that apply)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

Welcome Friend of

ClickMore

Immune Response & Mold Disease Evaluation

Section 1: Sinus History

1. How many sinus infections have you had in the past year?
 
 
 
 
 
 
2. How many times a month do you have sinus headaches (not migraines)?
 
 
 
 
 
 
3. How many times have you taken antibiotics in the last year?
 
 
 
 
 
 
4. Have you had aspirin allergy?
 
 
5. Do you have loss of smell?
 
 
6. Do you have nasal airway obstruction?
 
 
 
 
 
7. Do you have postnasal drip?
 
 
 
 
 
8. Do you have allergies (non-food)?
 
 
9. How many sinus surgeries have you had?

Section 2: Your Environment

10. Has the furnace or air conditioner location in your home ever been damp?
 
 
11. Is the heater or air conditioner located in a dirt crawl space?
 
 
12. Is your crawl space damp?
 
 
13. Is the heater located in the attic with blown-in insulation?
 
 
14. Do you have a humidifier in the central furnace?
 
 
15. Have you had a leak or flood anywhere in your home?
 
 
16. Do you ever notice a musty smell in the house?
 
 
17. Have you noticed any mold in the house (other than the bathroom shower/tub)?
 
 
18. Do you feel better (physically) away from home
 
 
19. Do you feel better (physically) away from the office?
 
 
20. Do you or your co-workers feel bad at the office?
 
 
21. Do you feel better if you go to the beach or other clean air space?
 
 
22. Do you have pets in the home?
 
 
23. Do you sleep with your pets?
 
 

Section 3: Additional History

24. Do you experience fatigue or tiredness regularly?
Rate your level of fatigue:  0=can walk 5 miles        10=can’t get out of bed
25. Do you have any of the following? (Check all that apply)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

Welcome Customer of

Micro Balance Health

Immune Response & Mold Disease Evaluation

Section 1: Sinus History

1. How many sinus infections have you had in the past year?
 
 
 
 
 
 
2. How many times a month do you have sinus headaches (not migraines)?
 
 
 
 
 
 
3. How many times have you taken antibiotics in the last year?
 
 
 
 
 
 
4. Have you had aspirin allergy?
 
 
5. Do you have loss of smell?
 
 
6. Do you have nasal airway obstruction?
 
 
 
 
 
7. Do you have postnasal drip?
 
 
 
 
 
8. Do you have allergies (non-food)?
 
 
9. How many sinus surgeries have you had?

Section 2: Your Environment

10. Has the furnace or air conditioner location in your home ever been damp?
 
 
11. Is the heater or air conditioner located in a dirt crawl space?
 
 
12. Is your crawl space damp?
 
 
13. Is the heater located in the attic with blown-in insulation?
 
 
14. Do you have a humidifier in the central furnace?
 
 
15. Have you had a leak or flood anywhere in your home?
 
 
16. Do you ever notice a musty smell in the house?
 
 
17. Have you noticed any mold in the house (other than the bathroom shower/tub)?
 
 
18. Do you feel better (physically) away from home
 
 
19. Do you feel better (physically) away from the office?
 
 
20. Do you or your co-workers feel bad at the office?
 
 
21. Do you feel better if you go to the beach or other clean air space?
 
 
22. Do you have pets in the home?
 
 
23. Do you sleep with your pets?
 
 

Section 3: Additional History

24. Do you experience fatigue or tiredness regularly?
Rate your level of fatigue:  0=can walk 5 miles        10=can’t get out of bed
25. Do you have any of the following? (Check all that apply)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

Welcome Patient of

DR. Frank

Immune Response & Mold Disease Evaluation

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About This Site

This site reflects the knowledge and views of Donald P. Dennis, M.D., F.A.C.S. of Atlanta, GA. The intent of this site is to bring his successful techniques for achieving wellness for sufferers of chronic and fungal sinusitis using an all-natural approach to a broader audience.

Disclaimer

This site nor any of the products mentioned herein claim to diagnose, treat, cure or prevent any disease or replace the care of physicians. The Food and Drug Administration has not evaluated these statements.

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