Copyright 2007 Hear Health Inc.
™
“So you can hear the music”
HOW DO I KNOW IF I HAVE TINNITUS?
Please take this Tinnitus Evaluation Test and note your score. There are 20 questions. Choose the answer that best describes your condition. After you have finished the test keep your results.
You can dowload the test as a word document by clicking this link:
After 3 months of taking EarAid™ repeat the Tinnitus Test again. This will tell you how much improvement you have made. Did your tinnitus improve? By how much?
We would appreciate it if you would send us your before and after scores so that we can compile research data. This is how doctors and researchers evaluate the effectiveness of their treatments. By doing this evaluation on the internet we can gather hundreds of results in a short time compared to only a small number in the clinic. Your information will help other tinnitus patients.
After you have taken the test twice, please forward your two scores to TinnitusEvaluation@yahoo.com so we can compile the results. It is not necessary to give your name or any other information. Your information will be private and secure; it is only for research purposes. Any questions? Please contact Dora at EARAID@yahoo.com or by calling 818-893-6202
We are here to help. Please visit our web site again for Q & A and up to date information. We can only answer general questions about EarAid™ nutritional supplement, not specific medical advice. For medical questions consult your doctor. For hearing and masking questions, consult your audiologist.
The EarAid™ Tinnitus Test
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Tinnitus Score: Please rate all questions on a scale from 1 – 5.
0 – Never at all3 – It is a mild problem
1 – Slight or Occasional 4 – It is definitely a problem
2 – It is sometimes a problem5 – It is a severe problem occurring all the time
QUESTIONS
1.Because of your tinnitus is it hard to concentrate?
2.Does tinnitus interfere with your sleep?
3.Does the loudness of your tinnitus make it difficult for you to hear people?
4.Does your tinnitus make you angry?
5.Because of your tinnitus do you feel desperate?
6.Do you have trouble falling sleep at night?
7.Does your tinnitus interfere with your social life (Restaurants, movies, parties?)
8.Because of your tinnitus do you feel frustrated?
9. Does your tinnitus make it difficult for you to enjoy everyday life activities?
10. Does your tinnitus interfere with your job?
11.Because of your tinnitus are you often irritable?
12.Because of your tinnitus is it hard to read?
13.Because of your tinnitus do you often feel tired?
14.Because of your tinnitus have you sought or taken antidepressant medication?
15.Because of your tinnitus do you feel anxious?
16.Does your tinnitus get worse under stress?
17.Is it difficult to turn you attention away from your tinnitus for games or recreation?
18.Does your tinnitus make you upset?
19. Does your tinnitus control you?
20. Does your tinnitus bother you even when you are relaxed, even with relaxed breathing and thinking?
Date: _________ Your Total Score: ____________
