QUESTIONNAIRES

1. Gender
Male
Female

2. Your profession:
Student
Staff UiTM
Lecturer

3. Age: __________
4. Any history of serious illness?
Yes
No

5. Do you have a sinus infection?

Yes
No

6. Do you regularly sneeze in the morning?

Yes
No

If yes, how frequent?

Normal
Moderate
Frequent

If yes, any mucus contagious?

Yes
No
7. Do you smoke or vape, etc.?
Yes
No

If yes, how frequent?

Normal
Moderate
Frequent

8. Do you have other disease besides of sinusitis?

If yes, please state below:
Yes (name of disease: ___________________)
No

9. Do you have allergy?

Yes
No

If yes, what are you allergic to?

Seafood
Vegetables
Chicken
Dust
Cats
Meat
Other: __________

10. Your level of sinusitis is:

Medium
Mild
Chronic
11. Have you taken any treatment for your sinusitis?
Yes
No

If yes, what is the method of treatment?

Traditional
Private clinic
Specialist
Normal procedure

12. Do you have any proper diagnosed from doctor or specialist?

Yes
No

13. Do you have family members with sinus infection too?

Yes
No

If yes, whom?
Mother
Sibling
Father
Other

14. Have you had a problem in breathing during

Day
Sleep

15. Do you snore during sleep?

Yes
No
16. Do you live in environment of:
Rural
Intermediate
City

17. Do you think sinusitis can be healed?

Yes
Why: ____________________________
No
Why: ____________________________

18. Do you know the cause of sinusitis?

Yes
No

If yes, please choose the cause that you know:

Viruses
Pollutants
Fungi
Bacteria
Other: __________