Find a Doctor

Search by Name

Search by Specialty

Search by Insurance

Search Within            Zipcode

  of  

Search Within

 miles of  

 
Main Content

Vestibular Rehabilitation Evaluation

Answer the questions below to determine if you could benefit from vestibular rehabilitation therapy.

Questions
Text
Do you feel dizzy with any of the following: turning over in bed (rolling), moving from lying down to sitting, moving from sitting to standing, turning your head or looking up and down?
Answers
Text Yes
Score 1
Text No
Score 0
Text
Do you often feel off-balance, unstable, or like you may fall?
Answers
Text Yes
Score 1
Text No
Score 0
Text
Have you fallen in the past 3 months due to dizziness?
Answers
Text Yes
Score 1
Text No
Score 0
Text
Do you require a cane or walker to walk because of poor balance or a fear of falling?
Answers
Text Yes
Score 1
Text No
Score 0
Text
Do you ever experience dizziness when going to tie your shoes or with bending over to pick something up?
Answers
Text Yes
Score 1
Text No
Score 0
Text
Do you experience the sensation of spinning (vertigo) when you feel dizzy?
Answers
Text Yes
Score 1
Text No
Score 0
Text
Does your dizziness last less than 15-30 seconds when you change postitions or turn your head?
Answers
Text Yes
Score 1
Text No
Score 0
Text
Do you experience nausea or vomiting with the onset of dizziness?
Answers
Text Yes
Score 1
Text No
Score 0
  
Bottom Content

*This vestibular rehabilitation evaluation provides general medical information that should be used for informative and educational purposes only. Your results should not be used as a substitute for the personal, professional medical advice of your physician. 
Response Content

Vestibular Rehabilitation Evaluation

Thank you for completing the evaluation.  Your results are below.

Scoring Ranges
Minimum 0
Maximum 0
Text

Your answers indicate that you do not experience any symptoms that would benefit from vestibular rehabilitation therapy.

Learn more about Vestibular Rehabilitation at Good Samaritan Hospital.

Minimum 1
Maximum 8
Text

Your answers indicate that you experience one or more symptoms that would benefit from vestibular rehabilitation therapy.  We urge you to discuss your symptoms with your physician.

Do you not have a family doctor?  Search and Find a Doctor online.

Learn more about Vestibular Rehabilitation at Good Samaritan Hospital.