Home AIB Dizzy Self Quiz Patient Self Quiz for Dizziness & Balance Problems A feeling of motion, spinning or falling when moving your head quickly or changing your position? (Ex. Getting in and out of bed)yesno Uncomfortable trying to get around in the dark?yesno Walking down the grocery store aisles or through the mall is upsetting?yesno Your feet just won't go where you want them to?yesno A sense of unsteadiness? A feeling you are not surefooted?yesno A fear of falling or stumbling?yesno Looking at moving objects such as escalators or looking out the side window of a car makes you queasy?yesno Difficulty keeping your balance as you walk on different surfaces? (Ex. Tile to carpet)yesno A feeling like you are drifting or being pulled to one side when walking?yesno No one really understands how frustrating this is?yesno Your Score: Your balance and equilibrium appears to be okay. It is imperative that you schedule an appointment. Please fill out the quick form below: Name *Last Name *Email *Phone *
