Veteran Hearing Loss Study

Thank-you for your service to our nation and for taking a few minutes to complete this questionnaire regarding hearing loss among the Veteran community. The information collected from this study is completely anonymous and personal information will not be asked at any point during the survey. Your honest responses will help us better understand all aspects of the transition process. Our goal is to gather, analyze, and share this information with veterans, individuals considering a separation or retirement from the military, and those currently in transition from the military.

This study is being conducted by a group of independent veterans with the goal of helping our community and those currently serving in the military. This study is not sponsored by or affiliated with the Department of Defense or the US Government.

Participation should take less than 15 minutes and is completely anonymous. We ask that you provide honest responses so that we can best help our current and future military veterans.

Are you currently on active duty, a reservist, guardsman, or a military veteran?
In which branch or branches did you serve?
When did you serve on active duty in the U.S. Armed Forces?
Did you deploy in support of Operation Enduring Freedom (OEF) or Operation Iraqi Freedom (OIF)?
Did you ever serve in a combat or war zone?
[NOTE: Persons serving in a combat or war zone usually receive combat zone tax exclusion, imminent danger pay, or hostile fire pay.]
Do you have a VA service-connected disability rating?
Briefly describe your duties during your time of service
Have you ever had a hearing screening?
Do you currently wear a hearing device?
Do you have a problem hearing over the phone?

Do you have trouble following the conversation when two or more people are talking at the same time?

Do people complain that you turn the TV volume too high?

Do you have to strain to understand conversations?

Do you have trouble hearing conversations in a noisy background such as a party?

Do you miss hearing some common sounds like the phone or doorbell ring?

Do you get confused about where sounds come from?

Do you misunderstand some words in a sentence and need to ask people to repeat themselves?

Have you worked in noisy environments?

Many people mumble when they talk

People get annoyed because I misunderstand what is being said

Do you misunderstand what others are saying and make inappropriate responses?

Do you avoid social activities because you cannot hear well and fear that you will reply improperly?

Have you experienced a ringing, buzzing, humming or other noises in your ears or head, lasting more than 2-3 minutes?

Have you experienced ringing, buzzing, humming or other noises in your ears or head for at least 6 months?

In a quiet room can you hear a ringing, buzzing, humming or other noises in your ears or head?

Does this ringing, buzzing, humming or other noises in your ears or head cause you to lose sleep?

Have you applied for a disability rating with the VA for any hearing related issues including the ringing, buzzing, humming, or other noises in your ears or head (tinnitus)?
What was the outcome of the disability rating?

Are you happy with the health care services you receive from the VA?

Have you used the Veterans Choice Program?

Thank-you for participating in our study.