Hearing Assessment

Take the Hearing Assessment (H.H.I.E-S)

We will not share your name or email address...

Once you have submitted the following form one of our Hearing Specialists will contact you with your results.

Your Name (required)

Your Email (required)

Your Phone (required)

Does a hearing problem cause you to feel embarrassed when you meet new people?

YesSometimesNo

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

YesSometimesNo

Do you have difficulty hearing when someone speaks in a whisper?

YesSometimesNo

Do you feel handicapped by a hearing problem?

YesSometimesNo

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

YesSometimesNo

Does a hearing problem cause you to attend religious services less often than you would like?

YesSometimesNo

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

YesSometimesNo

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

YesSometimesNo

Do you feel that any difficulty with your hearing limits 
or hampers your personal or social life?

YesSometimesNo

Does a hearing problem cause you difficulty when in a restaurant with relatives or friends?

YesSometimesNo

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