SWAL-QOL Hoarseness or a problem with your voice 0 1 2 3 4 5Clearing your throat 0 1 2 3 4 5Excess throat or mucous post-nasal drip 0 1 2 3 4 5Difficulty swallowing food, liquids or pills 0 1 2 3 4 5Coughing after you ate or after lying down 0 1 2 3 4 5Breathing difficulties or choking episodes 0 1 2 3 4 5Sensations of something sticking in your throat 0 1 2 3 4 5Heartburn, chest pain, indigestion, or stomach acid coming up 0 1 2 3 4 5 Name DOB Email Phone number Please contact me by email Please contact me by phone Time is Up!
