Hearing Survey

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Please answer each question below to the best of your ability. When you click submit, we will review the results and contact you to discuss any hearing issues you may be having.

Do you have to strain to understand conversations? Almost Always Half the Time Occasionally Never

Are there situations in which you find it difficult to hear clearly?Almost Always Half the Time Occasionally Never

Do you have a problem hearing over the telephone? Almost Always Half the Time Occasionally Never

Do you have trouble following a conversation when two or more people are talking at the same time? Almost Always Half the Time Occasionally Never

Do you have trouble hearing conversations in a noisy background such as a restaurant or a group gathering? Almost Always Half the Time Occasionally Never

Do you have dizziness, pain, or ringing in your ears? Almost Always Half the Time OccasionallyNever

Do family members or coworkers remark about your missing what has been said? Almost Always Half the Time OccasionallyNever

Do people complain that you turn the TV volume up too high? Almost Always Half the Time Occasionally Never

Do you find it hard to hear someone when they talk in a soft voice or whisper? Almost Always Half the Time Occasionally Never

Do you find understanding women and children particularly challenging? Almost Always Half the Time Half the Time Never

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