The purpose of these questions is to calculate a severity score of epistaxis (nose bleeding) for patients with Hereditary Hemorrhagic Telangiectasia. Treatment for epistaxis should be determined by a care provider with experience in treating patients with HHT, and this calculation should serve as an adjunct to clinical evaluation. For more information regarding the meaning of this score, please discuss this with you health care provider.
 

 
Please answer each of the following questions as they pertain to your TYPICAL symptoms WITHIN THE LAST 3 MONTHS for nose bleeding. Please answer all questions.



  





 

  





  


  


  



  






     

 
Note: The HHT-ESS was developed by Jeffrey B. Hoag, M.D., M.S. from Drexel University College of Medicine in conjunction with Christian A. Merlo, M.D., M.P.H. and members of The Johns Hopkins University HHT Center of Excellence.