Member Survey

The National Hearing Test

Hearing Screening By Phone

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Pre-Test Survey

Before you take the National Hearing Test, please provide the following information.

The questions are optional and for research purposes only. All information is confidential. If you do not supply an email address, your test access code will be displayed only on this website during this session.

1.  Please provide your email address to receive your access code by email. Note: A valid email address is required to receive your test access code by email.

2.  Have you had regular exposure to intense noise? Examples include factory noise, heavy machinery, loud equipment, and gunfire.

3.  Have you had frequent exposure to loud music?

4.  What is your age?

5.  What is your sex?

 
6.  Please indicate your race/ethnicity. Check ALL that apply:






7.  How did you learn of the National Hearing Test? Check ALL that apply:








The National Hearing Test is provided by Communication Disorders Technology, Inc. By taking the hearing test you agree to NHT’s terms and conditions and privacy policy.