Hearing Loss Evaluation Questionnaire

The questionnaire on this page helps you evaluate if you might be suffering from hearing loss. This evaluation does not replace a professional hearing test but the results can indicate whether or not it may be worth seeking advice from a hearing care professional.

Hearing loss can sometimes occur due to treatable causes such as excessive wax buildup or an ear infection. Consult a medical professional qualified in the treatment and management of ear diseases. An audiologist can then test your hearing and fit you with a hearing aid.

If you wish to directly set up an evaluation for hearing loss with one of Quadio's highly-qualified and certified professionals, click to fill a form to book an appointment at Quadio Hearing Clinics, currently in Gujarat, Maharashtra and Uttar Pradesh.

Our expert audiologists will help you find a solution that fits perfectly for your degree of hearing loss, your budget and and your lifestyle to ensure that you enjoy the activities that you like the most.

Answer the questions below to check if you suffer from hearing loss and require an evaluation from an audiologist:

Do you struggle to hear what people say to you on the telephone? *
Do you frequently ask people to repeat what they are saying? *
Do you have difficulty listening to TV at a volume others consider normal? *
Do you have face difficulty in hearing people talking to you in restaurants/ background noise? *
Do you typically have trouble understanding conversations or people in a group? *
Do you have any present complaint or past history of ear pain or ear discharge? *
Do you struggle with hearing female and/or children’s voices? *
Do you find it difficult to hear the door bell or the telephone ring? *
Does anyone in your family have hearing difficulty? *
Do you feel your hearing has deteriorated following use of any medication? *
Are you frequently exposed to very loud noises? *
Name *
Name

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