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Hearing Self-Assessment
Yes No
 1. Do you have difficulty understanding speech in a group of people?
 2. Do you often ask that statements, questions, and directions be repeated?
 3. Do you hear people speaking, but have difficulty understanding the words?
 4. Must others ever raise their voices or move closer to help you hear them?
 5. Do you have to turn the television up louder than normal to hear clearly?
 6. Do you have to concentrate so much to listen that you tire from it?
 7. Have you ever avoided a situation because of your hearing problem?
 8. Do you have difficulty understanding conversations in the car?
 9. Do you have difficulty understanding on the phone?
 10. Do you hear some people better than others?
Number of YES answers x 10______ = _____% Hearing Difficulty
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