This questionnaire is designed to find out what sort of effects tinnitus has had on your lifestyle, general well-being, etc.
Some of the effects below may apply to you, some may not.
Please answer all questions by selecting the number that
best reflects how your tinnitus has affected you over the past week.
Rank your responses from 0 – Not at all to 4 – Almost all of the time
Your results show you either have no or little signs tinnitus is currently interfering with your life. Over time, you may want to take the assessment again to see if things change. If you do have concerns, please discuss them with us during your next hearing exam. This is simply a self-assessment. During your appointment, we will conduct a more thorough and complete assessment. Call our office to schedule an appointment today (423) 641-0956.
Your results have indicated you experience a moderate to a significant negative impact on your life from tinnitus. Please call our office to schedule an appointment (423) 641-0956. Along with baseline or updated hearing evaluation, we can discuss potential treatment options that may offer you some relief. We would be honored to help you.
If you have ranked any of these questions with a high score, call our office at 423-641-0956 if you would like to schedule an appointment for a more thorough assessment.