Phone make and model

examples: iPhone 8, Samsung Galaxy S8

Before answering the following questions, let us clarify what we mean by “hearing device”

We include prescription hearing aids, over-the-counter, non-prescription hearing devices, wireless and wired headphones or ear buds, etc.

My hearing device is not one of the above

Please specify

Brand of hearing device(s)

Please list all if you own more than one

Which, if any, gateway/relay/mic devices do use with your hearing aids or implants?

Examples: Roger, Phonak ComPilot, Oticon ConnectLine, TV connector, ...

I have used hearing-assistive devices for:

Please indicate the cost range of your primary device

If a pair, use the total cost

Rank the degree of difficulty you have hearing conversation in a noisy environment

Please indicate your age range:

If HeardThat has worked well for you, can you tell us in what circumstances you used it?

If you tried HeardThat and it didn’t work well for you, how were you trying it?

If you'd like us to follow up with about any of your comments, please provide your email address here:

Please click the SUBMIT button when you have finished.

Thank you for taking the time to fill out this questionnaire!