How bad is your heartburn?
Heartburn when lying down?
Heartburn when standing up?
Heartburn after meals?
Does heartburn change your diet?
Does heartburn wake you from sleep?
Do you have difficulty swallowing?
Do you have pain with swallowing?
Do you have bloating or gassy feelings?
If you take medications, does this affect your daily life?
If you experience regurgitation, how bad is it?
Are you currently taking any medications for heartburn, reflux or GERD?