TINNITUS HANDICAP INVENTORY Once submitted, a copy of this questionnaire will be sent to our office. Your Name* Your Email* Please leave this field empty. Phone* Because of your Tinnitus, is it difficult for you to concentrate? YesSometimesNo Does the loudness of your Tinnitus make it difficult for you to hear people? YesSometimesNo Does your Tinnitus make you angry? YesSometimesNo Does your Tinnitus make you feel confused? YesSometimesNo Because of your Tinnitus, do you feel desperate? YesSometimesNo Do you complain a great deal about your Tinnitus? YesSometimesNo Because of your Tinnitus, do have trouble falling asleep at night? YesSometimesNo Do you feel as though you cannot escape your Tinnitus? YesSometimesNo Does your Tinnitus interfere with your ability to enjoy social activities? (e.g. going out to dinner, to the movies, etc.) YesSometimesNo Because of your Tinnitus, do you feel frustrated? YesSometimesNo Because of your Tinnitus, do you feel you have a terrible disease? YesSometimesNo Does your Tinnitus make it difficult for you to enjoy your life?* YesSometimesNo Does your Tinnitus interfere with your job or household responsibilities? YesSometimesNo Because of your Tinnitus, do you find that you often are irritable? YesSometimesNo Because of your Tinnitus, is it difficult for you to read? YesSometimesNo Does your Tinnitus make you upset? YesSometimesNo Do you feel that your Tinnitus has placed stress on your relationships (e.g. family members or friends)? YesSometimesNo Do you find it difficult to focus your attention away from your Tinnitus on to other things? YesSometimesNo Do you feel you have no control over your Tinnitus? YesSometimesNo Because of your Tinnitus, do you feel tired? YesSometimesNo Because of your Tinnitus, do you often feel depressed? YesSometimesNo Does your Tinnitus make you feel anxious? YesSometimesNo Do you feel you can no longer cope with your Tinnitus? YesSometimesNo Does your Tinnitus get worse under stress? YesSometimesNo Does your Tinnitus make you feel insecure? YesSometimesNo Δ Tinnitus Treatment Tinnitus Questionnaire Tinnitus Handicap Inventory Tinnitus FAQ Why Wait? You don’t have to live with ringing in your ears. CALL US TODAY Why Wait? You don’t have to live with ringing in your ears. CALL US TODAY