Answer each question as truthfully as possible. Add one point for each question answered "Yes."

1. Do you have a problem hearing on the telephone? 2. Do you have trouble following the conversation when two or more people are talking at the same time? 3. Do people complain that you have the TV volume too high? 4. Do you have to strain to understand conversation? 5. Do you miss hearing some common sounds like the phone or doorbell ringing? 6. Do you have trouble hearing conversations in a noisy background, such as a party? 7. Do you get confused as to where sounds come from? 8. Do you misunderstand some words in a sentence and need to ask people to repeat themselves? 9. Do you have trouble understanding the speech of women and children? 10. Have you worked in noisy environments without ear protection for 3 or more months? 11. Do many people seem to mumble? 12. Do you avoid social activities because you fear being embarrased by making improper responses to questions? 13. Does anyone in your family or a close friend think you have hearing loss? Scoring: (Number of questions you answered Yes.) 0 - 3 points: Your hearing is most likely within normal limits. 4 - 7 points: Suggest you have your hearing tested and/or see an ear-nose-and-throat specialist. 7 or more points: Strongly recommend you see an ear physician and receive counseling on hearing amplification devices.