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We Listen
So You Can Hear

Hearing Survey

	ALMOST ALWAYS	HALF THE TIME	OCCASIONALLY	NEVER
Are there situations in which you find it difficult to hear clearly?
Do you have to strain to understand conversations?
Do you have a problem hearing over the telephone?
Do you have trouble following a conversation when two or more people are talking at the same time?
Do you have trouble hearing conversations in a noisy background such as a restaurant or a group gathering?
Do you have dizziness, pain, or ringing in your ears?
Do family members or coworkers remark about you missing what has been said?
Do people complain that you turn the TV volume up too high?
Do you find it hard to hear someone when they talk in a soft voice or whisper?
Do you find understanding women and children particularly challenging?

Name

Email(Required)

Phone(Required)

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