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Hearing Loss Questionnaire
What are some of the signs that I may be losing my hearing?

Answer YES or NO to each of these question:

Feel that people are often mumbling or not speaking clearly

Ask others to repeat themselves frequently

Have difficulty hearing on the telephone

Turn the volume up on the television or radio louder
than other people

Have trouble hearing in a theater, church or other public gatherings

Have difficulty understanding conversations in a group

Have difficulty understanding people when you cannot
see their faces

Avoid noisy rooms, social occasions or family gatherings

Remember: A hearing loss is more noticeable than a hearing aid.

Chagrin Hearing:: 512 E. Washing Street, Chagrin Falls, Ohio 44022

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