How well do you hear?

After each of the following questions, score:
4 = Yes, 2 = Sometimes, 0 = No

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

0 2 4

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

0 2 4

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

0 2 4

Do you feel handicapped by a hearing problem?

0 2 4

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

0 2 4

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

0 2 4

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

0 2 4

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

0 2 4

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

0 2 4

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

0 2 4