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Total Nasal Symptom Score

Please answer all questions to the best of your ability. This information will assist us in
understanding and treating symptoms.

Please rate the following rhinitis symptom for the last week:

1. Nasal obstruction
No Symptoms 0
Mild – awareness but not troubled 1
Moderate – troublesome but not interfering with normal daily activities or sleep 2
Severe – interfering with normal daily activities or sleep 3

on
2. Itching/Sneezing
No Symptoms 0

si
Mild – awareness but not troubled 1
Moderate – troublesome but not interfering with normal daily activities or sleep 2

is
Severe – interfering with normal daily activities or sleep 3

m
tp y
3. Secretion/runny nose
ou op
er
No Symptoms 0
ith C
Mild – awareness but not troubled 1
Moderate – troublesome but not interfering with normal daily activities or sleep 2
w ew

Severe – interfering with normal daily activities or sleep 3


se vi
t u Re

Total Score: _____


9
no
o
D

TNSS © Janet Rimmer, 2004. All Rights Reserved

TNSS – Australia/English – Original version


TNSS_AU1.0_eng-AUori.doc

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