on hearing loss and hearing instruments.
1. Do people around you seem to mumble? YesNo
2. Have you ever been embarrassed because you couldn't hear or misunderstood something being said to you? YesNo
3. Do you often ask people to repeat themselves? YesNo
4. Do you have trouble hearing on the telephone? YesNo
5. Does your family complain that you play the TV or radio too loudly? YesNo
6. Do you sometimes have trouble hearing household sounds like a faucet dripping, a clock ticking or a doorbell ringing? YesNo
7. Is it hard to hear when you can't see the speaker's face? YesNo
8. Do some people say that you speak too loudly? YesNo
9. Have you ever experienced ringing in your ears? YesNo
10. Are conversations in restaurants or crowded places difficult? YesNo