Cornerstone Audiology

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Balance Self Test:

Please complete the following questionnaire regarding dizziness and imbalance. If you answer yes to any of the following questions, call today and schedule an evaluation with an audiologist at Cornerstone Audiology.

 

1. Have you fallen more than once in the past year?

2. Do you take medication to help with dizziness?

3. Do you feel dizzy or unsteady when you make sudden changes in movement (e.g., bending over or standing up quickly)?

4. Do you feel unsteady when you are walking or climbing stairs?

5. Have you noticed that when walking you veer to a certain side or that you typically fall to a certain side?

6. Do you have difficulty sitting down or rising from a seated or lying position?

7. Do you have black outs or seizures?

8. Have you had a stroke?

9. Do you experience numbness or tingling in your legs or feet?

10. Have you experienced head trauma, recent or past?