Dizziness and Vertigo Pre-Exam Form in Chapman
Rolling over in bed should not be the most dangerous thing you do all day. Before you come to our Chapman clinic, here is everything your therapist will ask, so you can work out the details while you are sitting still rather than trying to explain them mid episode.
What your dizziness and vertigo pre-exam covers.
The word “dizzy” covers several very different experiences. A room that spins is not the same as a head that feels like it might go out, and neither is the same as simply feeling unsteady on your feet. They come from different systems, and sorting out which one you have is the whole point of the first visit.
That is what these questions do. Read them over beforehand and answer what you can. Nothing is submitted here and nothing needs printing. When you want to be seen, the booking form further down the page handles it.
Spinning, or lightheaded
Choose the closer word. Does the room move around you, or does your head swim as though you might grey out? Some people describe feeling drunk without drinking, others say the floor tips. Whichever fits, tell us whether it happens when you are completely still or only when you move.
Dizziness & vertigo →What sets it off
Rolling over in bed. Lying flat, or sitting back up again. Looking up to a high shelf. Bending to pick something off the floor. Standing too quickly. Turning your head to check traffic. The trigger is often the single most useful detail you can give us, so try to catch which movement starts it.
Vestibular therapy →How long it lasts, and what comes with it
Seconds, a couple of minutes, hours, or a whole day that never fully clears. Then what travels with it: nausea, vomiting, sweating, a headache. Note any change in hearing, ringing, or a full plugged feeling in one ear, and whether it is always the same ear.
Request an appointment →Head injury and history
Any recent blow to the head, concussion, whiplash or car accident, including the one you brushed off at the time. Ear infections, ear surgery, migraines. If dizziness comes with sudden severe headache, double vision, slurred speech or new weakness on one side, treat that as an emergency and seek medical care immediately.
Call (785) 922-4016 →What to bring to your first visit
- Your prescription, if a physician has already written you one
- Your driver’s licence or another photo ID
- Your insurance cards, or your Worker’s Comp or auto claim information
- A list of your medications with the dosage and how often you take them
- Copies of any X-ray, MRI or CT reports, and any ENT or hearing test results
- Your personal calendar, so we can schedule the rest of your visits before you leave
It is worth bringing a driver, because some vestibular testing can stir symptoms up for a short while. Kansas direct access means most patients can start physical therapy without a physician referral. Some insurance plans still require one for coverage, so we verify your specific plan before your first visit and tell you exactly where you stand.
Your Chapman clinic
Tues and Thurs, 7:20 am to 5:00 pm
If looking at a screen makes your symptoms worse, put it down. Call (785) 922-4016 and answer these on the phone instead, or arrive a few minutes early and go through them with us at the front desk. Nobody is turned away for showing up with nothing prepared. Use the form below and we will call you back with a time.