1.   Do you find it difficult to follow a conversation in a noisy restaurant or crowded room?
Yes
Sometimes
No

2.   Do you sometimes feel that people are mumbling or not speaking clearly?
Yes
Sometimes
No

3.   Do you experience difficulty following dialog in the theater?
Yes
Sometimes
No

4.   Do you sometimes find it difficult to understand a speaker at a public meeting or a religious service?
Yes
Sometimes
No

5.   Do you find yourself asking people to speak up or repeat themselves?
Yes
Sometimes
No

6.   Do you find men's voices easier to understand than women\'s?
Yes
Sometimes
No

7.   Do you experience difficulty understanding soft or whispered speech?
Yes
Sometimes
No

8.   Do you sometimes have difficulty understanding speech on the telephone?
Yes
Sometimes
No

9.   Does a hearing problem cause you to feel embarrassed when meeting new people?
Yes
Sometimes
No

10.   Do you feel handicapped by a hearing problem?
Yes
Sometimes
No

11.   Does a hearing problem cause you to visit friends, relatives or neighbors less often than you would like?
Yes
Sometimes
No

12.   Do you experience ringing or noises in your ears?
Yes
Sometimes
No

13.   Do you hear better with one ear than the other?
Yes
No

14.   Have you had any significant noise exposure during work, recreation or military service?
Yes
No

15.   Have any of your relatives (by birth) had a hearing loss?
Yes
No

Comment:

To manually score the Hearing Health Quick Test, score 2 points for Yes, 1 point for Sometimes, and 0 points for No. Scores of 3 or more may mean that you have a hearing problem. Scores of 6 or more strongly suggest that a hearing check is warranted. In either case, ask your doctor to screen your hearing. Further testing by an Hearing Health Care professional may be recommended.