Hearing Questionnaire

Early identification and management of hearing loss can help limit the negative impact on a person's life and allow for more effective and timely treatments. It is important to consult your doctor if you suspect that your hearing might be impaired.

This screening questionnaire and Amplifon's online hearing test can help you determine if you need to get your hearing evaluated.

1 of  16

I have had complaints that I listen to TV/Radio at a very loud volume.

2 of  16

It is difficult to follow a conversation with two or more people talking at the same time.

3 of  16

I have problems hearing over the telephone.

4 of  16

Understanding conversations is challenging and straining.

5 of  16

I have difficulties hearing conversations in a noisy background.

6 of  16

I miss the phone ringing, doorbell, or similar noises.

7 of  16

It is hard for me to locate the source/direction of a sound.

8 of  16

I need to ask people to repeat what they said, because I misunderstand some words in their sentences

9 of  16

I have trouble hearing women, children, and high pitched noises.

10 of  16

A lot of people I talk to seem to not talk clearly and mumble.

11 of  16

I have history working in noisy environments (such as construction sites).

12 of  16

I misunderstand what others are saying, which makes them upset.

13 of  16

I misunderstand what others are saying, so sometimes I make inappropriate responses.

14 of  16

I avoid social activities because I cannot hear well.

15 of  16

Does your friends/family believe you have hearing loss?

16 of  16

Does hearing loss run in your family?

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