Research on Hearing Loss Questionnaire

Do you have at least 5 years experience of profound or total hearing loss? Fred, a student at Southampton University is doing some research on the effects of hearing loss. Aim is to gather data about the mutual experiences by asking the affected. He would be delighted if you could help. The questionnaire is available by downloading and saving the link below:

Questionnaire (PDF format: 346kb).  You will need Adobe Reader 8 or above to fill in this form.  In the unlikely event that you have a version older than this, please click here to get the latest version.

The questionnaire could take a while to fill in and we do not want you to rush it.  So feel free to take your time. Your questionnaire and answers can be saved at any time, to allow you to fill it out in two or more sessions.

This form is posted on our website to help Fred reach as many people as possible.  We are unable to provide any help with this Questionnaire.  If you need assistance, please follow the advice and contact details contained within.

Please return your completed form as instructed by July 15th 2013.