None

Slight

Mild

Bad

Intense

Severe

1. Need to blow nose

x

x

x

x

x

x

2. Nasal blockage

x

x

x

x

x

x

3. Sneezing

x

x

x

x

x

x

4. Runny nose

x

x

x

x

x

x

5. Cough

x

x

x

x

x

x

6. Post-nasal discharge

x

x

x

x

x

x

7. Thick nasal discharge

x

x

x

x

x

x

8. Ear fullness

x

x

x

x

x

x

9. Dizziness

x

x

x

x

x

x

10. Ear pain

x

x

x

x

x

x

11. Facial pain/pressure

x

x

x

x

x

x

12. Decreased sense of smell/taste

x

x

x

x

x

x

13. Difficulty falling asleep

x

x

x

x

x

x

14. Wake up at night

x

x

x

x

x

x

15. Lack of a good night’s sleep

x

x

x

x

x

x

16. Wake up tired

x

x

x

x

x

x

17. Fatigue

x

x

x

x

x

x

18. Reduced productivity

x

x

x

x

x

x

19. Reduced concentration

x

x

x

x

x

x

20. Frustrated/restless/irritable

x

x

x

x

x

x

21. Sad

x

x

x

x

x

x

22. Embarrassed

x

x

x

x

x

x

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