1) Do you find it difficult to follow a conversation
in a noisy restaurant or crowded room?

2) Do you sometimes feel that people are mumbling or not speaking clearly?

3) Do you experience difficulty following dialog in the theater?

4) Do you sometimes find it difficult to understand a speaker at a public meeting or a religious service?

5) Do you find yourself asking people to speak up or repeat themselves?

6) Do you find men's voices easier to understand than women's?

7) Do you experience difficulty understanding soft or whispered speech?

8) Do you sometimes have difficulty understanding speech on the telephone?

9) When you meet new people, do you have trouble understanding them?

10) Are friends and loved ones complaining that you have trouble hearing them?

11) Do you avoid social situations or visit friends, relatives or neighbors less often than you would like?

12) Do you experience ringing or noises in your ears?

13) Do you hear better with one ear than the other?

14) Have you had any significant noise exposure during work, recreation or military service?

15) Have any of your relatives (by birth) had a hearing loss?