Danny W. Gnewikow, PhD, FAAA
Audiologist, CCC
Founder & Chief Audiologist

 

Danville, VA
  (434) 799-6288

Lynchburg, VA
  (434) 528-4245

Do I Need a Hearing Aid?

Hearing Loss Questionnaire

(Weinstein, 1992)

Is hearing loss affecting my quality of life?

Click on the options below that best relates to your situation. Your score will be calculated for you at the bottom left corner.

QUESTIONS YES
Four (4) Points
NO
Zero (0) Points
SOMETIMES
Two (2) Points
1. Does a hearing problem cause you to feel embarrassed when meeting new people?
2. Does a hearing problem cause you to feel frustrated when talking to members of your family?
3. Do you have difficulty hearing when someone speaks in a whisper?
4. Do you feel handicapped by a hearing problem?
5. Does a hearing problem cause you difficulty when visiting friends, relatives, or neighbors?
6. Does a hearing problem cause you to attend religious services less often than you would like?
7. Does a hearing problem cause you to have arguments with family members?
8. Does a hearing problem cause you difficulty when listening to TV or radio?
9. Do you feel that any difficulty with your hearing limits or hampers your personal or social life?
10. Does a hearing problem cause you difficulty when in a restaurant with relatives and friends?

MY SCORE:   

Scoring Overview:

  • 0-10 = no handicap
  • 11-26 = mild to moderate
                 handicap
  • 27-40 = significant handicap

Click for a Printable version of the Questionnaire