Vertigo Screening Advanced Vertigo Screening Tool Comprehensive Vertigo & Dizziness Screening Questionnaire Patient Details 1. What do you feel? (Select all) Spinning sensation Imbalance Lightheadedness Tilting / swaying 2. Episode Pattern (TiTrATE) Episodic with symptom-free intervals Continuous dizziness Seconds Minutes Hours Days 3. Positional Triggers (Select all) Rolling in bed Sitting up from lying Bending forward Looking upward 4. Side Consistency Always same side Changes sides Unsure 5. Ear Symptoms (Select all) Hearing loss Tinnitus Ear fullness 6. Neurological RED FLAGS (Select all) Double vision Slurred speech Limb weakness / numbness Severe headache / blackout 7. Migraine Features (Select all) Known migraine Photophobia / phonophobia Visual aura 8. Chronic Dizziness (PPPD screen) Dizziness most days > 3 months Worse in crowds / supermarkets Better when lying down 9. Neck & Cardiovascular Screen Neck pain / stiffness Blackouts / near fainting Dizziness on standing Palpitations 10. Severity Mild (0–3) Moderate (4–6) Severe (7–10) Generate Result Download PDF Report
