Island Hearing Services - Digital Hearing Aids and Audiological Services

Hearing Evaluations

Many people experience hearing loss over a long period of time, and do not notice their reduced hearing abilities. The purpose of the following test is to assist you in identifying whether or not you are experiencing a hearing loss and what problems you experience as a result of it.

Please read each question carefully and select the appropriate check box. After completion click on the "Count Checkboxes" button at the bottom of the form to tally your score.

1. Please check the box if you can not distinguish these sounds?
  1. Refrigerator
  2. Running Water
  3. Clock Ticking
  4. Furnace
  5. Dishwasher motor grinds and growls
  6. Telephone Ringing
  7. Newspapers rustling and crackling
  8. Glasses clink when filling with ice
  9. Microwave fan hums
2. People complain I speak too loudly.
3. I have trouble hearing conversations in a noisy background.
4. I have difficulty hearing someone calling from another room.
5. I misunderstand and have trouble hearing women and children.
6. People seem to mumble; I have to ask them to repeat themselves.
7. I have worked in a noisy environment (factory, construction site, near jet engines or in traffic).
8. I get confused about where sounds come from.
9. In public situations I have to strain to hear conversations.
10. I feel frustrated watching television with others because I can not hear the program.
11. My hearing problem causes misunderstandings in the work place, and with friends and family.
12. I am embarrassed by my hearing problem.
13. I avoid social situations and activities because I cannot hear well.

Scoring

"Yes" 6 or less times
Result: No action required

"Yes" 7 or more times
Result: Contact Island Hearing for a hearing test
(Link to our contact page & locations page)

For more information please contact info@islandhearing.com or the Island Hearing location closest to you.
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Island Hearing | 309-645 Fort Street | Victoria, British Columbia | Canada, V8W 1G2
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