Do you need a hearing check?

Hearing Wellington

If you answer yes to two or more questions you may have hearing loss

Do you have difficulty understanding speach in a group of people?

Tick for yes
Leave blank for no

Do you often ask for people to repeat themselves?

Tick for yes
Leave blank for no

Do you hear people speaking, but find it difficult to understand clearly?

Tick for yes
Leave blank for no

Do other people need to raise their voices or move closer to you for you to hear them?

Tick for yes
Leave blank for no

Do you have to turn the TV volume up high to hear clearly?

Tick for yes
Leave blank for no

Do you get tired from having to concentrate when you listen?

Tick for yes
Leave blank for no

Do you avoid social situations like restaurants?

Tick for yes
Leave blank for no

Do you have trouble hearing conversations in the car?

Tick for yes
Leave blank for no

Do you have trouble understanding conversations on the phone?

Tick for yes
Leave blank for no

Does your hearing affect your work or relationships?

Tick for yes
Leave blank for no

Please fill this section out if you would like us to contact you to book a hearing check or if you have any questions about your hearing.

Persons name

First name

Last name

OK to email?

Email address

OK to call?

Phone

Or go visit our website to book