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The purpose of the scale is to identify the problems your
hearing loss may be causing you. Print this page then answer either Yes, Sometimes, or No for each of
the questions. Do not skip a question if you avoid a situation because of a
hearing problem. See below for scoring.
| Please read each question and check the box
that applies to you |
Yes |
Sometimes |
No |
| Does a hearing problem cause you to feel embarrassed
when meeting new people? |
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| Does a hearing problem cause you to feel frustrated
when talking to members of your family? |
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| Do you have difficulty hearing when someone
speaks in a whisper? |
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| Do you feel handicapped by a hearing problem? |
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| Does a hearing problem cause you difficulty
when visiting with friends, relatives or neighbors? |
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| Does a hearing problem cause you difficulty
in the movies, the theater or when attending religious services? |
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| Does a hearing problem cause you to have arguments
with family members? |
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| Does a hearing problem cause you difficulty
when listening to TV or radio? |
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| Do you feel that any difficulty with your hearing
limits or hampers your personal or social life? |
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| Does a hearing problem cause you difficulty
when in a restaurant with relatives or friends? |
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Using the scoring formula shown below calculate the total
number of points scored
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Scoring
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Yes = 4 pts
Sometimes = 2 pts
No = 0 pts |
If you scored higher than 8 pts on this Test Your Hearing questionnaire
it is highly recommended that you make an appointment for a hearing evaluation
that is conducted by a professional hearing health care provider. If you suspect
a hearing loss, call your doctor, or visit the Island Hearing location
nearest you. We can help!
Test
Your Hearing | How We Hear | Hearing
Loss | Communicating with the Hard of Hearing
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