Bayside Voice Centre

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Certified Practising Speech Pathologist, Cleveland

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Reflux Symptom Index (RSI)

These are statements that many people have used to describe their voices and the effects of their voices on their lives.  Select the response that indicates how frequently you have had the same experience in the last 4 weeks.  If you do not have a problem with reflux, please select zero (0) in response to these questions.

0 = Never
1 = Almost Never
2 = Sometimes
3 = Almost Always
4 = Always

The results of these questions will be sent to your Speech Pathologist who will discuss them with you at your next appointment.

0 = Never / 1 = Almost never / 2 = Sometimes / 3 = Almost always / 4 = Always
0 = Never / 1 = Almost never / 2 = Sometimes / 3 = Almost always / 4 = Always
0 = Never / 1 = Almost never / 2 = Sometimes / 3 = Almost always / 4 = Always
0 = Never / 1 = Almost never / 2 = Sometimes / 3 = Almost always / 4 = Always
0 = Never / 1 = Almost never / 2 = Sometimes / 3 = Almost always / 4 = Always
0 = Never / 1 = Almost never / 2 = Sometimes / 3 = Almost always / 4 = Always
0 = Never / 1 = Almost never / 2 = Sometimes / 3 = Almost always / 4 = Always
0 = Never / 1 = Almost never / 2 = Sometimes / 3 = Almost always / 4 = Always
0 = Never / 1 = Almost never / 2 = Sometimes / 3 = Almost always / 4 = Always

Belafsky, P. C., Postma, G. N., & Koufman, J. A. (2002). Validity and reliability of the reflux symptom index (RSI). J Voice, 16(2), 274-277.

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