Do I have hearing loss?

Ten Ways To Recognize Hearing Loss Questionaire

Please circle the response that applies to you

1. Do you have a problem hearing over the telephone?

Yes No

2. Do you have trouble following the conversation when two or more people are talking at the same time?

Yes No

3. Do people complain that you turn the TV volume up too high?

Yes No

4. Do you have to strain to understand conversation?

Yes No

5. Do you have trouble hearing in a noisy background?

Yes No

6. Do you find yourself asking people to repeat themselves?

Yes No

7. Do many people you talk to seem to mumble (or not speak clearly)?

Yes No

8. Do you misunderstand what others are saying and respond inappropriately?

Yes No

9. Do you have trouble understanding the speech of women and children?

Yes No

10. Do people get annoyed because you misunderstand what they say?

Yes No

Enter the code as it is shown: *

Answering "Yes" to three or more questions strongly suggests that a hearing evaluation is warranted.

Contact an audiologist at Professional Hearing Services at 262-549-5150, with locations in Waukesha, New Berlin, and Mukwonago. You can also visit us at www.professionalhearingservices.com.

Patients Survey taken from www.nidcd.nih.gov.