Abbreviated Profile of Hearing Aid Benefit

Please select the answers that come closest to your everyday experience. Each choice includes a percentage to help you decide on your answer. If you have not experienced the situation described, try to think of a similar situation. If you have no idea, leave that item blank.

Step 1 of 813%

Patient details

Please enter the patient's name and the date this questionnaire was completed.

Patient nameDate

PATIENT QUESTIONNAIRE

Abbreviated Profile of Hearing Aid Benefit

Please select the answers that come closest to your everyday experience. Each choice includes a percentage to help you decide on your answer. If you have not experienced the situation described, try to think of a similar situation. If you have no idea, leave that item blank.

Step 1 of 813%

Patient details

Please enter the patient's name and the date this questionnaire was completed.

Patient nameDate

PATIENT QUESTIONNAIRE

Abbreviated Profile of Hearing Aid Benefit

Please select the answers that come closest to your everyday experience. Each choice includes a percentage to help you decide on your answer. If you have not experienced the situation described, try to think of a similar situation. If you have no idea, leave that item blank.

Step 1 of 813%