Hearing Health Quick Test

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Hearing Health Quick Test

This test is courtesy of Carol Atkins Audiology; contact information is below the questions.

Check YES or NO or SOMETIMES for each question.

1. Do you find it difficult to follow a conversation in a noisy restaurant or crowded room?

( )Yes ( ) No  ( ) Sometimes

2. Do you sometimes feel that people are mumbling or not speaking clearly?

 ( )Yes   ( ) No  ( ) Sometimes

3. Do you experience difficulty following dialog in the theater? 

( ) Yes   ( ) No  ( ) Sometimes

4. Do you sometimes find it difficult to understand a speaker at a public meeting or a religious service? 

( ) Yes   ( ) No  ( ) Sometimes

5. Do you find yourself asking people to speak up or repeat themselves?

( ) Yes  ( ) No  ( ) Sometimes

6. Do you find men’s voices easier to understand than women’s? 

( ) Yes   ( ) No  ( ) Sometimes

7. Do you experience difficulty understanding soft or whispered speech?

( ) Yes   ( ) No  ( ) Sometimes

8. Do you sometimes have difficulty understanding speech on the telephone?

( ) Yes   ( )  No  ( ) Sometimes

9. Does a hearing problem cause you to feel embarrassed when meeting new people?

( ) Yes   ( ) No  ( ) Sometimes 

10. Does a hearing problem cause you to visit friends, relatives or neighbors less often than you would like?

 ( ) Yes   ( ) No   ( ) Sometimes

11. Do you experience ringing or noises in your ears? 

( ) Yes ( ) No  ( ) Sometimes

12. Do you hear better with one ear than the other?

( )  Yes  ( ) No  ( ) Sometimes 

Scoring: Score 2 points for Yes, 1 point for Sometimes and 0 points for No. Scores of 3 or more may mean that you have a hearing problem. Scores of 6 or more strongly suggest that a hearing check is warranted.

CAROL ATKINS AUDIOLOGY

25255 Cabot Road #108 

Laguna Hills, CA 92653

949.951.3362

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