Hearing Aid Assessment - Hearing Needs

The purpose of this assessment is to identify the problems your hearing loss may be causing you. Please answer Yes, Sometimes or No for each question. Click Submit to receive your final score and FREE comprehensive hearing aid guide.

Does a hearing problem cause you to feel embarrassed when meeting new people?
YesSometimes No

Does a hearing problem cause you to feel frustrated when talking to members of your family?
YesSometimesNo

Do you feel handicapped by a hearing problem?
YesSometimesNo

Does a hearing problem cause you difficulty when visiting friends, family, or neighbors?
YesSometimesNo

Does a hearing problem cause you difficulty hearing/understanding co-workers, clients, or customers?
YesSometimesNo

Does a hearing problem cause you difficulty at the movies or at a theater?
YesSometimesNo

Does a hearing problem cause you to have arguments with family members?
YesSometimesNo

Does a hearing problem cause you difficulty when listening to the TV or radio?
YesSometimesNo

Does difficulty with your hearing limit or hamper your personal or social life?
YesSometimesNo

Does a hearing problem cause you difficulty when at a restaurant with friends or family?
YesSometimesNo

To get your final score and download your free hearing aid guide,
please provide the following:

* First Name:

* Last Name:

Street Address

Street Address 2:

City

State

* Zip:

* Email Address:

Phone Number: -

* Date of Birth: / /

Yes, I would like to receive additional
information from Cleveland Clinic.

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