You can always press Enter⏎ to continue
assistive-listening
Hearing Quiz
15
Questions
START
1
Do you feel there are situations where you find it challenging to hear as well as you would like?
*
This field is required.
Almost Always
Half the Time
Occasionally
Never
Previous
Next
Submit
Press
Enter
2
Do family members, friends or coworkers ever tell you that you are not hearing well or that you are missing hearing what has been said?
*
This field is required.
Almost Always
Half the Time
Occasionally
Never
Previous
Next
Submit
Press
Enter
3
Do you have difficulty following a conversation when there are multiple people talking at the same time?
*
This field is required.
Almost Always
Half the Time
Occasionally
Never
Previous
Next
Submit
Press
Enter
4
Do you find it challenging to hear in a noisy environment like a restaurant?
*
This field is required.
Almost Always
Half the Time
Occasionally
Never
Previous
Next
Submit
Press
Enter
5
Does anyone ever tell you that you turn the TV up too loud?
*
This field is required.
Almost Always
Half the Time
Occasionally
Never
Previous
Next
Submit
Press
Enter
6
Do you ever experience ringing or other noises in your ears?
*
This field is required.
Almost Always
Half the Time
Occasionally
Never
Previous
Next
Submit
Press
Enter
7
Do you ever experience dizziness?
*
This field is required.
Almost Always
Half the Time
Occasionally
Never
Previous
Next
Submit
Press
Enter
8
Do you find it challenging to hear on the telephone?
*
This field is required.
Almost Always
Half the Time
Occasionally
Never
Previous
Next
Submit
Press
Enter
9
Do you find yourself avoiding certain situations because you know you will have a hard time hearing as well as you would like?
*
This field is required.
Almost Always
Half the Time
Occasionally
Never
Previous
Next
Submit
Press
Enter
10
Do you ever feel embarrassed that you have misunderstood or not heard something?
*
This field is required.
Almost Always
Half the Time
Occasionally
Never
Previous
Next
Submit
Press
Enter
11
Fill out the following information for your score.
Previous
Next
Submit
Press
Enter
12
Name
*
This field is required.
First Name
Last Name
Previous
Next
Submit
Press
Enter
13
Phone Number
*
This field is required.
Area Code
Phone Number
Previous
Next
Submit
Press
Enter
14
Email
*
This field is required.
example@example.com
Previous
Next
Submit
Press
Enter
15
Score
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
15
See All
Go Back
Submit