0%

Hearing Healthcare Screening Questionnaire for Adults

1 / 10

1) Does a hearing problem cause you to feel embarrassed when you meet new people?

2 / 10

2) Does a hearing problem cause you to feel frustrated when talking to family members?

3 / 10

3) Do you have difficulty hearing or understanding co-workers, clients or customers?

4 / 10

4) Do you feel handicapped by a hearing problem?

5 / 10

5) Does a hearing problem causeyou difficulty when visiting friends, relatives or neighbors?

6 / 10

6) Does a hearing problem cause you difficulty in the movies or in the theater?

7 / 10

7) Does a hearing problem cause you to have arguments with family members?

8 / 10

8) Does a hearing problem cause you difficulty when listening to TV or radio?

9 / 10

9) Does lack of hearing hamper your personal or social life?

10 / 10

10) Does a hearing problem cause you difficulty when in a restaurant with friends?

Your score is

0%

Adapted from: Ventry, I., Weinstein, B. “Identification of elderly people with hearing problems”.
American Speech-Language-Hearing Association. 1983, 25, 37-42.

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