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Tinnitus Questionnaire

Please remember that no online test can take the place of advice from a physician who is able to give you an exam. 
This is simply a guide and should not be used in place of care.

Please fill out the following information so that your results can be sent to you!

Name
Email
Phone Number
Because of your tinnitus, is it difficult for you to concentrate?
Does the loudness of your tinnitus make it difficult for you to hear people?
Does your tinnitus make you angry?
Does your tinnitus make you feel confused?
Because of your tinnitus, do you feel desperate?
Do you complain a great deal about your tinnitus?
Because of your tinnitus, do you have trouble falling to sleep at night?
Do you feel as though you cannot escape your tinnitus?
Does your tinnitus interfere with your ability to enjoy your social activities (such as going out to dinner, to the movies)?
Because of your tinnitus, do you feel frustrated?
Because of your tinnitus, do you feel that you have a terrible disease?
Does your tinnitus make it difficult for you to enjoy life?
Does your tinnitus interfere with your job or household responsibilities?
Because of your tinnitus, do you find that you are often irritable?
Because of your tinnitus, is it difficult for you to read?
Does your tinnitus make you upset?
Do you feel that your tinnitus problem has placed stress on your relationships with members of your family and friends?
Do you find it difficult to focus your attention away from your tinnitus and on other things?
Do you feel that you have no control over your tinnitus?
Because of your tinnitus, do you often feel tired?
Because of your tinnitus, do you feel depressed?
Does your tinnitus make you feel anxious?
Do you feel that you can no longer cope with your tinnitus?
Does your tinnitus get worse when you are under stress?
Does your tinnitus make you feel insecure?

What Makes Us Right For You?

It begins with a sincere question, “What brings you here, today?” At PHH, we pride ourselves in getting to the root of your concerns regarding you or your loved-one’s communicative difficulties… whether it’s problems understanding grandchildren talking when they come to visit or problems understanding a spouse or coworkers, we are here to help you.

It is not unique to see our waiting rooms full of mothers, fathers, sisters, brothers, and grandparents… not to mention a close friend or an aunt or uncle from time to time. It is important to note that we communicate with the people around us… so THEY are the key to building and acheiving success in a hearing rehabilitative program.

Do you have questions?
``Blindness cuts us off from things, but deafness cuts us off from people...``

– Helen Keller