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TAKE THE HEARING
LOSS SURVEY

LISTEN TO
CHAPTER 2

Do you have hearing loss?

Select all that apply.

I ask people to repeat themselves often.

I can't hear someone calling me from the other room.

People complain that I turn the television up too loud.

I have difficulty hearing people on the telephone.

I have difficulty understanding the dialogue at movies.

I have trouble listening to the news on my car radio.

I have to ask people to speak slowly to me.

I can't understand conversations in a noisy place like a restaurant.

It seems like people mumble a lot when speaking to me.

I skip social events because I'm afraid I won't hear people.

I have trouble hearing consonants.

I have trouble hearing high pitched sounds like a doorbell.

I am hypersensitive to certain sounds (e.g. emergency sirens, construction noise, loud music)

I get frustrated because I can't make out what people say.

I have ringing in my ears.

If you or a loved one is experiencing any of the above symptoms, contact Arizona Hearing Center for a No Risk Ultimate Hearing Loss Treatment Consultation and Test at 602-277-HEAR (4327) or at scheduling@azhear.com

Time is Up!

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