Learn if You May Have GERD

  

Within the past 12 months, have you experienced any of the following symptoms: heartburn, chest burn, chest pain, coughing, voice transformation, hoarseness, uncomfortable feelings radiating from the chest and throat, constant earache or sinusitis?

Severity

Frequency


Within the past 12 months, have you ever had gastric acid reflux?

Severity

Frequency


Within the past 12 months, have you ever had gastric acid reflux coming up to your throat?

Severity

Frequency


In the past 12 months, how many times did you take antacids or other medicines for stomach ailments?

Severity

Frequency

You have not filled in all of the assessment answers. Please fill in all of the questions and resubmit!
Contact the Reflux and Heart Burn Center at 702-894-5555 to schedule a consultation. The earlier you address your symptoms, the better your outcome will be. You can also fill out the form below to have a representative contact you.
You may not have GERD. For more information contact the Reflux and Heart Burn Center at 702-894-5555.