Tinnitus Handicap Inventory The purpose of this questionnaire is to identify difficulties that you may be experiencing because of your tinnitus. Please answer every question. Please do not skip any questions. 1. Because of your tinnitus, is it difficult for you to concentrate? Yes Sometimes No None 2. Does the loudness of your tinnitus make it difficult for you to hear people? Yes Sometimes No None 3. Does your tinnitus make you angry? Yes Sometimes No None 4. Does your tinnitus make you feel confused? Yes Sometimes No None 5. Because of your tinnitus, do you feel desperate? Yes Sometimes No None 6. Do you complain a great deal about your tinnitus? Yes Sometimes No None 7. Because of your tinnitus, do you have trouble falling to sleep at night? Yes Sometimes No None 8. Do you feel as though you cannot escape your tinnitus? Yes Sometimes No None 9. Does your tinnitus interfere with your ability to enjoy your social activities (such as going out to dinner, to the movies)? Yes Sometimes No None 10. Because of your tinnitus, do you feel frustrated? Yes Sometimes No None 11. Because of your tinnitus, do you feel that you have a terrible disease? Yes Sometimes No None 12. Does your tinnitus make it difficult for you to enjoy life? Yes Sometimes No None 13. Does your tinnitus interfere with your job or household responsibilities? Yes Sometimes No None 14. Because of your tinnitus, do you find that you are often irritable? Yes Sometimes No None 15. Because of your tinnitus, is it difficult for you to read? Yes Sometimes No None 16. Does your tinnitus make you upset? Yes Sometimes No None 17. Do you feel that your tinnitus problem has placed stress on your relationships with members of your family and friends? Yes Sometimes No None 18. Do you find it difficult to focus your attention away from your tinnitus and on other things? Yes Sometimes No None 19. Do you feel that you have no control over your tinnitus? Yes Sometimes No None 20. Because of your tinnitus, do you often feel tired? Yes Sometimes No None 21. Because of your tinnitus, do you feel depressed? Yes Sometimes No None 22. Does your tinnitus make you feel anxious? Yes Sometimes No None 23. Do you feel that you can no longer cope with your tinnitus? Yes Sometimes No None 24. Does your tinnitus get worse when you are under stress? Yes Sometimes No None 25. Does your tinnitus make you feel insecure? Yes Sometimes No None First Name Last Name Email Phone Date of Birth Time's up
