Forms

Click on a link to download PDF forms:

Battery Sizes

Client History

JAMA Report

Myths

16 Reasons Why 2 Hearing Aids Are Best

Score your own hearing screening

Below is a link to the printable version of the “Score Your Own Hearing Screening” form.

Score Your Own Hearing Screening

Please click on the link and print out and answer the 10 questions. You will then be able to score the results based on the information provided below.

SCORING:

Yes

= 4

Sometimes

= 2

No

= 0

RESULTS:

0-8

There is only a 13% probability that you have a measurable hearing impairment.

10-24

There is a 50% probability that you have a hearing impairment and it is recommended that you have an audiometric threshold screening by a qualified hearing healthcare provider.

25-40

There is an 84% chance that you have a serious hearing impairment. It is highly recommended that you have a hearing evaluation by a hearing healthcare provider.

Bookmark It