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Self-assessment questionnaire
Do you often ask "What"?
Yes
No
Do you complain that the people around you don't speak clearly or articulate enough?
Yes
No
Have friends or family told you that you don’t hear well?
Yes
No
Do you have to increase the volume of the television or radio and does it bother others?
Yes
No
Have you noticed that you make people repeat what they say on the phone?
Yes
No
Do you have trouble hearing birds sing? (All birds, not just crows.)
Yes
No
Do you have trouble understanding people who speak quietly?
Yes
No
Do you feel tired after a long conversation?
Yes
No
Do you have trouble understanding what people around you are saying during receptions?
Yes
No
Do you have trouble understanding speech in noisy environments?
Yes
No
Do you hear "blinking" or buzzing in your ears?
Yes
No
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