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Hearing Handicap Inventory
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Yes |
Sometimes |
No |
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4 |
2 |
0 |
El - Does a hearing problem cause you to feel embarrassed when you meet new people?
E2 - Does a hearing problem cause you to feel frustrated when talking to members of your family?
S1 - Do you have difficulty hearing when someone speaks in a whisper?
E3 - Do you feel handicapped by a hearing problem?
S2 - Does a hearing problem cause you difficulty when visiting friends, relatives or neighbors?
S3 - Does a hearing problem cause you to attend religious services less often than you would like?
E4 - Does a hearing problem cause you to have arguments with family members?
S4 - Does a hearing problem cause you difficulty when listening to TV or radio?
E5 - Do you feel that any difficulty with your hearing limits or hampers your personal or social life?
S5 - Does a hearing problem cause you difficulty when in a restaurant with relatives or friends?
INSTRUCTIONS: The purpose of this questionnaire is to identify the problems the hearing loss may be causing your spouse. Answer YES, SOMETIMES, or NO for each question. To obtain a total score, add up the "yes" (4 points), "sometimes" (2 points), and "no" (0 points) responses. If the score is greater than 10, a hearing test is recommended.
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Yes |
Sometimes |
No |
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4 |
2 |
0 |
S5 - Does a hearing problem cause you difficulty when in a restaurant with relatives or friends?
821 N. Bethlehem Pike
P.O. Box 619
Spring House,
PA 19477
(215) 641-1317
alicia@heargal.com
Serving Ambler, Blue Bell, Center Square, Dresher, East Norriton,
Fort Washington, Gwynedd, Hatboro, Horsham, Kulpsville, Lansdale,
Maple Glen, Montgomeryville, North Wales, Roslyn,
Spring House, Willow Grove, and other Eastern Montgomery County Pennsylvania communities.