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Hearing health pre-assessment questionnaire
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Hearing test
Do your family, friends, and co-workers have to repeat themselves? *
Yes
No
Occasionally
Do you think people mumble or don't express themselves clearly? *
Yes
No
Occasionally
Do you feel tired or have difficulty concentrating? *
Yes
No
Occasionally
Are you known for listening to the TV or radio too loudly? *
Yes
No
Occasionally
Do you find it difficult to follow conversations in a noisy environment? *
Yes
No
Occasionally
Do you have trouble understanding when you can't see the speaker's face? *
Yes
No
Occasionally
Do you sometimes miss the doorbell or telephone ring? *
Yes
No
Occasionally
Do you isolate yourself for fear of not understanding what others are saying? *
Yes
No
Occasionally
Last name *
First name *
Age *
Gender *
Occupation *
Postal code *
Email address *
Phone number *
SEND
Home
About us
Services
Hearing aids and accessories
Hearing difficulties
Age-related
45-55 year olds
Children
Occupational deafness
Tinnitus
Blog
Contact us
Français
TESTEZ VOTRE AUDITION
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Home
About us
Services
Hearing aids and accessories
Hearing difficulties
Age-related
45-55 year olds
Children
Occupational deafness
Tinnitus
Blog
Contact us
Français
Take our hearing test
Facebook-f
Linkedin-in
