PATIE T HEARING ASSES MENT Please circle the response Seldom Occasionally or O ften which best describes you lis tening a nd lifesty le needs
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PATIE T HEARING ASSES MENT Please circle the response Seldom Occasionally or O ften which best describes you lis tening a nd lifesty le needs

1 Others tell m I have a hearing problem Seldom Occasion lly Often 2 I experience difficulty hearing th e TV at a no rm al volum e level Seldom Occasion lly Often 3 I experience difficulty hearing on the telepho ne Seldom Occasion lly Often 4 I ac

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PATIE T HEARING ASSES MENT Please circle the response Seldom Occasionally or O ften which best describes you lis tening a nd lifesty le needs




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