Self assessment of communication

Please select an answer for each question. If you wear a hearing aid, answer according to how you do without the hearing aid.

Do you experience communication difficulties in situations when speaking with one other person? (for example, at home, at work, in a social situation, with a waitress, a store clerk, with a spouse, boss, etc.)
Do you experience communication difficulties in situations when conversing with a small group of several people? (for example, with friends or family, co-workers, in meetings or casual conversations, over dinner or while playing cards, etc.)
Do you experience communication difficulties while listening to someone speak to a large group? (for example, at a church or civic meeting, in a fraternal or women's club, at an educational lecture, etc.)
Do you experience communication difficulties while participating in various types of entertainment? (for example, movies, TV, radio, plays, night clubs, musical entertainment, etc.)
Do you experience communication difficulties when you are in an unfavorable listening environment? (for example, at a noisy party, where there is background music, when riding in an auto or bus, when someone whispers or talks from across the room, etc.)
Do you experience communication difficulties when using or listening to various communication devices? (for example, telephone ring, doorbell, public address system, warning signals, alarms, etc.)
Do you feel that any difficulty with your hearing limits or hampers your personal or social life?
Does any problem or difficulty with your hearing upset you?
Do others suggest that you have a hearing problem?
Do others leave you out of conversations or become annoyed because of your hearing?