Hearing Questionnaire

Not sure if you're ready or even need to make that first appointment? Our hearing questionnaire has been adapted from a self-assessment tool created by the American Academy of Otolaryngology. Please take the time to answer each question as accurately as possible. We will receive your information, email your results, and help you determine if a hearing test is necessary.

Name *
Name
Do people seem to mumble or speak in a softer voice more than they use to?
Do you feel tired or irritable after a long conversation?
Do you sometimes miss key words in a sentence?
Do you frequently need to ask people to repeat themselves?
Do you have difficulty understanding the conversation in a crowded room?
Do you often turn the volume up on the TV or radio?
Does background noise bother you?
Is it sometimes hard to hear the conversation on the telephone?
Do you sometimes not hear the doorbell or telephone ring?
Are your family or friends complaining about your hearing?