Dizziness Intake

A pre-visit history tool for your ENT clinic

Let's prepare for your visit

This short guided questionnaire collects a structured history of your dizziness so your ENT physician can review it before your appointment. It takes most patients about 5–8 minutes.

  • One simple question at a time
  • You can go back and change any answer
  • Your answers are organized into a summary for your doctor
Please note: This tool does not diagnose any condition. It only organizes your history so your doctor can evaluate you more efficiently. If you are experiencing a medical emergency — such as sudden severe headache, chest pain, difficulty speaking, weakness, or fainting — please seek emergency care immediately.

Organizing your history…

This will only take a moment.

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Your Pre-Visit Summary

Review this summary and share it with your ENT physician. This is decision-support information only — it is not a diagnosis.

Patient Summary

History of Present Illness (HPI)

Pertinent Positives

    Pertinent Negatives

      Possible Differential Diagnosis

        Potential Red Flags

          Missing Important Information

            Generated with AI assistance from a large language model using only the information you provided. This summary is intended as decision support for your physician and is not a medical diagnosis. It may be incomplete or inaccurate; clinical judgment and in-person examination remain necessary.