Do you experience ringing or noises in your ear?
Do you hear better with one ear than the other?
Have any of your relatives had a hearing loss?
Have you had significant noise exposure at work, recreation or in military service?
Do you find it difficult to follow a conversation in a noisy restaurant or a crowded room?
Do you sometimes feel people are mumbling or not speaking clearly?
Do you experience difficulty following dialog in the theater?
Do you sometimes find it difficult to understand a speaker at a public meeting or religious service?
Do you sometimes find yourself asking people to speak up or to repeat themselves?
Do you find men's voices easier to understand than women's?
Do you experience difficulty understanding soft or whispered speech?
Do you sometimes have difficultly understanding speech or words on the telephone?
Does a hearing problem cause you to feel embarrassed when meeting new people?
Do you feel handicapped by a hearing problem?
Does a hearing problem cause you to be nervous?
Does a hearing problem cause you to visit friends, relatives, or neighbors less often that you like?
Does a hearing problem cause you to talk to family members less often than you would like?
Does a hearing problem cause you to feel depresses?
