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Seven day sinus symptom diary
Name or initials ____________________ Week of ____________________
Overall labels. Clear, my usual, better than usual, worse than usual, or not recorded.
| Date | Overall | Blockage and side | Pressure and location | Smell | Impact or context |
|---|---|---|---|---|---|
| Day 1 | |||||
| Day 2 | |||||
| Day 3 | |||||
| Day 4 | |||||
| Day 5 | |||||
| Day 6 | |||||
| Day 7 |
Fictional completed week
| Date | Overall | Blockage and side | Pressure and location | Smell | Impact or context |
|---|---|---|---|---|---|
| Mon 7 Sep | My usual | Mild, both | None noticed | Unchanged | Usual work day |
| Tue 8 Sep | Worse | More blocked on left | Left cheek after lunch | Unchanged | Woke once overnight |
| Wed 9 Sep | Not recorded | No check-in | |||
| Thu 10 Sep | Worse | More blocked on left | Left cheek, brief | Unsure | Stopped once during a walk |
| Fri 11 Sep | My usual | Mild, both | None noticed | Unchanged | No impact noted |
| Sat 12 Sep | Better | Slight, right | None noticed | Unchanged | Slept through, as recalled |
| Sun 13 Sep | Clear | None at check-in | None at check-in | Normal for me | No impact noted |
Week recap. Six of seven days logged. Left side felt more blocked on two recorded days. Wednesday is unknown.
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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