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Sarasota Hearing AidsSarasota Speech Systems


Sarasota


Complete the questionnaire and address form then click on the 'submit' button (click reset to clear and start again)

Questions
Yes
No
     
Do your family and friends complain that your T.V. volume is too high for their listening comfort?
     
Do you often ask people to repeat themselves?
     
Do you feel that other people mumble?
     
Do you have trouble understanding a conversation when there is background noise or when people are all talking at the same time?
     
Have your family or friends ever suggested that you have a hearing problem?
     
Do you avoid going to parties and social events, because there is too much noise, which makes it difficult for you to hear what is being said?
     
Do you misunderstand what is being said, when in a restaurant or in a car?
     
Are young children's voices particularly difficult to understand?
     
Do you need to sit close to the speaker when in a meeting or at church?
     
Do you feel it is easier to hear when you look directly at the person who is talking?
     
Do you find it difficult to locate where a sound is coming from?

Answering YES to one or more of these questions, does not indicate that you have a hearing problem, however we would suggest that you contact us and we can arrange for you to have a Hearing Health check up, completely free of charge. Please fill in your details below and click on submit. We will then contact you to arrange for this Free service to be provided.

Name
 
Address
 
Eve. Tel. No.
 
Day Tel. No.
 
E-mail address
 
   


 

 


Contact Us
Hearing Aid & Speech Systems
SarasotaHearingAids.com
501 N. Beneva Road
Sarasota, FL. 34232
Tel: 941/953-4474
Toll Free: 800/949-4474

Venice Location (By Appointment Only):
628 Cypress Ave., Venice, FL. 34285
(941) 953-4454




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