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Sinus episode and gap worksheet

Date range ____________________ Note approximate dates where needed.

PeriodMain symptomsBetween boutsVisits and uncertainty
    
    
    
    
    
    
    
    

Between bouts, use “clear”, “ongoing” or “unknown”. If you returned to your usual symptoms and some remained, write down which ones.

Question to ask ____________________

Personal observations only. Not clinically reviewed. These sheets do not diagnose symptoms or replace your care team’s instructions. Do not delay care to complete a diary.

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