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? |
|
