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Test
Your Hearing | How
We Hear | Hearing
Loss | Communicating
with the Hard of Hearing
The
purpose of this scale is to identify the problems your hearing loss may be
causing you. Print this page out and 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.
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Please
read each question and check the box that applies to you
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Yes
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Sometimes
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No
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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
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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 come visit us at the location
nearest you. We Will Help!!!
Test
Your Hearing | How
We Hear | Hearing
Loss | Communicating
with the Hard of Hearing
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