Since how long has your voice been hoarse ? WeeksMonthsYears
Do you have any pain in the throat along with the hoarseness?YesNoOccasionally
Are you in a profession where you need to speak a lot ? YesNo
Does your voice become more hoarse towards the evening? YesNoOccasionally
Do you feel the need to clear your throat often? YesNo
Do you suffer from sinusitis? YesNoNot Sure
Is there a family history of cancer? YesNoNot Sure
Are you a smoker? YesNo
Have you had any investigations done? (If yes, then please mention the details of the reports in the 'more symptoms' column at the end of the questionnaire) YesNo
Are you already a patient with Dr.Manoj's Homeopathy? If yes, then please mention your Registration Number in the ‘more symptoms’ column. YesNo
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