Hearing Questionnaire

The following questions will help you determine if you, or a loved one, should have a hearing test performed by Dr. Robinson at Hearing Solutions Audiology Center.

There are two questionnaires to choose from. One is for you to answer about your own hearing. The other is about the hearing of a loved one. Just answer YES or NO to each question, then review the information that follows when finished.

Questionnaire: Do I have a hearing loss?

1. Do people always comment that the volume on your TV or radio is too loud?
2. Have you missed visits and calls from people because you didn't hear the doorbell or telephone ringing?
3. Do you have trouble following conversation in crowded or noisy settings?
4. Do people seem to mumble and not speak clearly during conversation?
5. Do people tell you that you speak too loudly in conversation?
6. Do you frequently ask people to repeat themselves?
7. Do your friends and family suggest that you have a hearing problem?
8. Do you have a difficult time understanding the words of popular songs when listening to the radio?

Questionnaire: Does someone I know have a hearing loss?

1. When you come to visit does the person you know hear your knock on the door or the doorbell?
2. Does the person you know complain about having a difficult time hearing on the telephone?
3. Does the person you know always ask you and others to repeat yourselves?
4. In crowded settings, does the person you know complain about not understanding what people are saying?
5. Does the person you know always turn the volume on the TV or radio up to an uncomfortable level just to hear a program or music?
6. Does the person you know often complain of ringing in the ears?

If you answered "YES" to 2 or more of these questions, you or your loved one may want to have a hearing test to determine if there's some degree of hearing loss.

Remember, detection of a hearing problem is the first step to improving your hearing health.

Questionnaires provided by Siemens