Ear - Check all that apply  
 
R
 L  
  Tinnitus (Ringing)
  Hearing Loss (please see below)

 If you answered yes to any of the above, please answer these questions.

Y or N  
Do people complain that you turn the TV volume too high?
Do you have trouble understanding conversation in background noise?
Has a friend or family member mentioned that you could have a hearing problem?
Do voices sound blurry - like people mumble?
Do you need to turn toward the person speaking or cup your ear to understand what is being said?