Atlanta VA Medical Center Tinnitus Program · Patients often confuse hearing problems with tinnitus problems. Interview format allows the audiologist to maintain a focus on issues

Atlanta VA Medical Center Tinnitus Protocol March 2013

Atlanta VA Medical Center

Tinnitus Program

Steven L Benton AuD

Revised March 2013

1670 Clairmont Road

Decatur GA 30033

Ph 404-235-3036


Progressive Tinnitus Management (PTM) Level 1

Triage

1 On the standard case history form patients are asked if they have tinnitus and to describe

the sound they perceive As noted those who experience tinnitus are asked to grade the

severity of their tinnitus using the THI-based grade levels described by McCombe et al

(2001)

2 Patients also are asked to describe how often they hear the tinnitus Patients may have

difficulty with this task

a Audiologists are encouraged to guide patients to provide an awareness

percentage (percentage of waking hours the patient hears the tinnitus)

b Otherwise audiologists may ask ldquo how often do you hear your tinnitus Once a

day once a weekhelliprdquo and ldquohow long does it last when you hear it A few

seconds a few minuteshelliprdquo

3 Patients who grade the tinnitus a 1 2 or 3 typically require no further tinnitus assessment

4 Patients who grade the tinnitus a 4 or 5 require further tinnitus screening

a The Tinnitus Severity Index or TSI (Meikle 1995) is completed This questionnaire

is best completed in an INTERVIEW FORMAT rather than by PAPERPENCIL

Patients often confuse hearing problems with tinnitus problems Interview

format allows the audiologist to maintain a focus on issues related to tinnitus

not hearing loss

b The questionnaire includes a 0-10 visual analog scale as well where 0 means

my tinnitus is not a problem at all and 10 means my tinnitus is the biggest

problem you can imagine

c Benton (2013) reported that a linear regression completed to evaluate the

predictive relationships between the independent variables 0-10 Problem and 1-

5 Tinnitus Grade and the dependent variable TSI Score resulted in the finding

that Not all of the independent variables appear necessary The following

appear to account for the ability to predict TSI (P lt 005) 0-10 VArdquoAs a result

the clinic now uses ONLY the 0-10 VAS as its single Triage measure



Audiological Evaluation

1 Comprehensive audiological assessment is completed

a Immittance

b Tympanometry

c Acoustic reflexes and reflex decay

i The possibility of loudness tolerance problems requires that reflex

measurement be begun at very low presentation levels

ii Patients should be instructed that if they cannot tolerate the tones

they should notify the audiologist and the test will be discontinued

immediately as a result accurate measurement of reflex thresholds

or reflex decay may not be possible

d Spondee thresholds

e Pure-tone thresholds

i If thresholds are normal from 25-8 kHz

1 Measure ultra high-frequency thresholds (9 10 112 125 kHz)

2 Measurement of DPOAEs is minimally helpful and is not

recommended Benton (2013) reported that up to 60 of normal-

hearing tinnitus patients have normal DPOAEs across all tested

frequencies depending on the criterion used Such poor specificity

and sensitivity renders the standard DPOAES useless

f Word-recognition scores (PI-PB function if indicated)

2 If the patient is unwilling or unable to provide valid behavioral test results further tinnitus

management is not possible Do not refer to Tinnitus Group Education


a Invalidfunctionalnonorganic results preclude appropriate counseling regarding

environmental sound enrichment as well as any other management strategy all

of which utilize sound and require accurate hearing threshold information

b Invalid voluntary responses also call into question the validity of tinnitus

complaints Counseling regarding the negative impact of invalid behavioral

responses on provision of tinnitus management services should be provided

c The audiologist should make every attempt to obtain valid behavioral responses

through retest following reinstruction in test procedures and counseling

regarding observed intra- and inter-test inconsistencies

d If invalid responses do not resolve retest at another time may be considered at

the audiologists discretion andor per clinic policy

3 All tinnitus findings are noted appropriately in the Tinnitus Section of the Audiology

Assessment Progress Note template

4 At this point regardless of responses to the Tinnitus Grading Scale and any score on the

Tinnitus Severity Index after audiologic evaluation all tinnitus patients should receive

a Appropriate counseling AND

b Assistive devices (eg Marsona Bedside Sound Generator Kit) if indicated

ANDOR

c Hearing aids if appropriate

5 Regarding the Marsona Bedside Sound Generator and Kit

a Demonstration of the device and available accessories is recommended

b Provision of the complete kit rather than individual items is strongly encouraged

During Tinnitus Group Education Class the vast majority of veterans who did not

receive the entire kit from their primary audiologist request the other

components when they hear of the benefits other veterans receive from the

various accessories


i The audiologist should immediately put in the appropriate consult

request to Prosthetics and instruct the veteran to pick up the kit there in

person

ii If the veteranrsquos appointment ends after 430pm Prosthetics will be

closed In such cases Prosthetics should be instructed to mail the kit and

the veteran should be instructed to expect the kit within 3 weeks of their

audiological evaluation appointment In the event the kit is not received

within 3 weeks the veteran should contact Prosthetics directly to inquire

c Audiologists are encouraged to provide the Marsona Kit handout and the Helpful

Tinnitus Information handout for the patientrsquos reference at home

6 If hearing aids are not appropriate schedule for Tinnitus Group Education if Triage criteria

are met

a Provision of the bedside sound generator and any accessories is NOT an

acceptable substitute for Tinnitus Group Education unless the patients ONLY

complaint is sleep disturbance and the patient concurs that attending Tinnitus

Group Education is not warranted

b NOTE Current hearing aid technology has expanded fitting ranges Careful

consideration should be given to providing hearing aids to patients whose

hearing levels are normal through 3000 Hz or whose high-frequency thresholds

are 30-35 dB HL given the proven significant tinnitus relief with aid use in this

population (Parazzini et al 2011)

7 If hearing aids are appropriate

a Although the conventional wisdom is that open fittings should be recommended

for tinnitus patients the main focus of the fitting should be audibility of

environmental sounds appropriate acoustic coupling for the individual patient

should be the primary consideration Progressive Tinnitus Management is based

upon the use of sound to manage tinnitus For sound to be effective it must be

audible

b Real-ear verification is required to assure that environmental sounds are audible

to the patient For tinnitus patients it is not JUST about speech


i Ricketts (JDVAC 2011) demonstrated that subjective fittings that rely

solely on the patients input regarding pleasantness or naturalness of the

hearing aid sound typically result in grossly inadequate gain

ii Manufacturersrsquo ldquofirst fitrdquo algorithms typically do not provide appropriate

amplification most often there is a gross under-fit relative to NALNL1

prescriptive gain targets

iii Although speech mapping is a valid tool for verifying the audibility of

speech comparison of hearing aids fit by this method compared to the

same aids fit using NALNL1 prescribed gain targets (65 dB SPL input)

reveal that speech mapping typically provides substantially less

amplification for soft and moderate inputs Traditional real-ear measures

(REIG) are recommended

c Maximum output of the aids must be verified to account for any tolerance

problems To evaluate both the effect of various algorithms on impulse sounds

as well as MPO loud clapping and very loud talking in the office have proven

effective

d Advanced features must be carefully considered during the fitting

i Expansion should be turned off or minimized (increasing gain for very soft

sounds) to avoid placing the patient in situations of distressing silence

where perceived tinnitus severity may be enhanced

ii Frequency-lowering methods differ significantly among the three on-

contract vendors offering this feature Non-linear frequency compression

limits high-frequency output above the cut-off frequency whereas

spectral feature identification does not Although no research exists to

suggest that either is better or worse for tinnitus patients (let alone that

either provides significant real-world benefit) limiting output in the high

frequencies where auditory contrast may most be needed may be a less

effective strategy for tinnitus patients

iii Experience with learning volume controls suggests that many patients ndash

especially new users ndash progressively turn their aids down and may

eventually reach the point of minimal if any amplification over time


Although this concern has been addressed by some manufacturers who

limit the maximum adjustment over time their aids can learn

audiologists are encouraged strongly to consider the possible impact of

learning VC on sound input for tinnitus patients

iv The possible impact of fast-acting noise management algorithms that

purport to reduce sound input between the syllables of speech also

should be carefully evaluated

v Data-log capabilities vary significantly among different brands of hearing

aids Some hearing aids provide average input data which can be useful in

counseling regarding environmental sound enrichment

vi Availability of accessories such as media streamers should be considered

when recommending hearing aids as a means of facilitating the use of

sound to manage tinnitus

e During the aid delivery but after programming while evaluating subjective

response to the aid(s) audiologists should inquire about any tinnitus relief

i How is your tinnitus now with your new hearing aids in place

ii The following numerical scale has proven useful On a scale of 0-10

where 0 means My hearing aids provide no tinnitus reliefrdquo and 10 means

My hearing aids provide complete tinnitus reliefrdquo how would you rate

your tinnitus right now Notate the immediate effect of the aids on the

tinnitus if any in the CPRS progress note

iii

1 Veteran was asked to utilize a 0-10 scale to assess the impact of

the new hearing aids on the tinnitus where 0 means My hearing

aids provide no tinnitus relief and 10 means My hearing aids

provide complete tinnitus relief Veteran rated the relief from

the hearing aids a _ confirming that the aid(s) areare not

providing adequate tinnitus relief

f HEARING AIDS MUST BE FIT AND THEIR EFFECTIVENESS FOR TINNITUS RELIEF

MUST BE EVALUATED PRIOR TO SCHEDULING FOR TINNITUS GROUP

EDUCATION


i Previous review of responses from hearing-impaired tinnitus patients at

the Atlanta VA indicates that 82 reported at least some tinnitus relief

from their hearing aids and fully 56 reported moderate to

majorcomplete relief from their hearing aids

ii If the patient reports no tinnitus relief during the fitting counsel

appropriately but do not schedule Tinnitus Group Education until after

the patient returns the IOI-HASatisfaction questionnaire 30 days later

The patients experiences in the sound-filled real world may differ

substantially from those in the quiet office

1 If the tinnitus patient returns the questionnaire and marks that

tinnitus relief is a 5 or less schedule the patient for Tinnitus

Group Education

2 An addendum to the HAE note must be added to document the

IOI-HASatisfaction questionnaire responses and whether or not

Tinnitus Group Education was scheduled

g All patients who are referred to Tinnitus Group Education in person should be

given a copy of the handout ldquoWhy Should I Attend the Tinnitus Classesrdquo

Audiologists should be prepared to answer any questions about the potential

benefits of attendance



Group Education

1 Group Education Class 1 (currently held on the second Tuesday of each month)

a Two hours in length

b Prior to the beginning of the class

i Patients are provided an envelope that they address to themselves This

envelope is later used to mail the Group Education outcome measure to

the patient

ii Patients are guided through completion of the Tinnitus Functional Index

or TFI (Meikle et al 2012) and the Physical Health Questionnaire or PHQ9

(Kroenke et al 2001) A different questionnaire previously utilized in the

Audiology Group Education session for baseline and outcome

measurement was the Tinnitus Reaction Questionnaire or TRQ (Wilson et

al 1991)

iii Patients are guided to provide estimates of the percentage of waking

hours that they are aware of their tinnitus (the Awareness ) and the

percentage of waking hours that they hear their tinnitus that it actually

disturbs them (the Disturbance ) on average over the past two weeks

These two values then are multiplied to calculate the Total Disturbance

the percentage of waking hours the veteran is disturbed by the

tinnitus

iv Benton (in progress) demonstrated a powerful correlation between

scores on the TFI and the PHQ9 The PHQ9 is a screening instrument for

depression for use by non-mental healthcare providers

1 Atlanta VA policy recommends that non-mental healthcare

providers complete the PHQ9 if a patient demonstrates suicidal

ideation


2 Benton (2010) reported that 33 of patients attending Group

Education reported suicidal ideation as a result of tinnitus based

on responses to Question 24 of the Tinnitus Reaction

Questionnaire or TRQ (Wilson et al 1991) the instrument

previously used for baseline and outcome measurements This

observation resulted in mental health screening via the PHQ9

being integrated into the Atlanta VA Tinnitus Program

3 Audiologists are encouraged to pursue an understanding of the

scoring guide to the PHQ9 and to utilize it only if they are

comfortable doing so

4 Based on the results of the PHQ9 primary care andor mental

health providers are added as cosigners to the Group Education

progress note and appropriate referrals are made

v The utility of the Tinnitus-Hearing Survey or THS (Henry et al 2008) is

being evaluated at this time Data thus far indicate that the majority of

tinnitus patients with clinically normal hearing thresholds respond that

hearing difficulty causes more problems than the tinnitus The findings

thus far suggest that the Tinnitus-Hearing Survey is not a helpful measure

and so it is not used

vi Patients are guided to estimate the percentage of waking hours that they

are aware of their tinnitus (Awareness Value) and the percentage of

the time they are aware of their tinnitus that it is truly disturbing

(Disturbance Value) These values are multiplied together to obtain a

single Total Disturbance value as a baseline measure

c Interactive slide presentation

i Various additional handouts are provided

ii Suicide prevention hotline information is included

1 Any attendees who respond positively to question 9 of the PHQ9

(ldquoThoughts of hurting yourself or that you might be better off

deadrdquo) are spoken to privately after the session and are offered

walk-in services at the Mental Health Clinic the audiologist

accompanies the patient if required or desired


iii The underlying causes of tinnitus generation and tinnitus disturbance

(discordant damagedysfunction theory and neurophysiological model of

tinnitus)

iv The use of different types of sound to manage tinnitus in different

problem situations is discussed and patients are guided to create Sound

Plans as a means of systematically evaluating different sounds for their

tinnitus-management effectiveness

v Homework is assigned (implementation and evaluation of Sound Plans)

and patients are reminded to be prepared to discuss their experiences at

the next session

d The Tinnitus Management Workbook (Henry et al 2010) is provided to each

attendee along with a demonstration of the CD and DVD included in each

workbook

e Progress note is entered into CPRS including information about mental health

diagnoses and hearing aid status are included

2 Group Education Class 2 (currently held on the fourth Tuesday of each month)


b Review of previously provided information

i The underlying causes of tinnitus generation and tinnitus disturbance


tinnitus)

ii Use of different types of sound to manage tinnitus in different problem

situations

iii Use of Sound Plans to systematically evaluate different sounds for their

effectiveness in providing tinnitus relief

c Review and discussion of homework - Sound Plan experiences

d Interactive slide presentation


e Various additional handouts are provided

f Progress note is completed

3 Outcome Measurement

a Four weeks after Class 2 all patients are mailed two outcome questionnaires

Self-Efficacy for Managing Reactions to Tinnitus or SMRT (VA NCRAR 2010) and

the PHQ9

i A cover letter is included that asks the patients to provide comments and

to share examples of any Sound Plans theyve utilized Relaxation

Exercises from which theyve benefited Pleasant Activities theyve tried

and how they may have been Changing Thoughts and Reactions to

Tinnitus General comments regarding their subjective impression of the

classes also are requested Finally the cover letter includes the critical

question ldquoDo you feel you need further assistance working with your

tinnitus YES NOrdquo

ii The outcome measure is sent to the patient using the self-addressed

envelope created at Class 1 A pre-addressed VA business-reply envelope

is included to facilitate return of the questionnaire at no charge to the

patient

b A total score is calculated for the SMRT

i All responses are added and divided by the number of questions

answered Total SMRT scores range from 0-10

ii The SMRT contains six items that are near-verbatim duplicates of the

items that make up the Self-Efficacy for Managing Chronic Disease 6-Item

Scale or SEMCD6 (Lorig et al 2001) Original psychometric data revealed

a mean score of 52 among 605 individuals with multiple chronic

diseases More recent normative data are available for a German version

of the scale (Freund et al 2011) and revealed a mean score of 67among

244 individuals with multiple chronic diseases


iii At the Atlanta VA we averaged the 849 SEMCD6 scores from the two

previous studies which resulted in a score of 56 We adopted this

composite score as the cutoff for the SMRT scale

iv The SMRT questionnaire also includes questions asking the veteran to

estimate his or her average Awareness and Disturbance for the

previous week

c Total Disturbance values also are calculated and compared

d Question 9 of the PHQ9 (ldquoThoughts of hurting yourself or that you might be

better off deadrdquo) is given special consideration with proper notation in the

progress note with cosigners added as noted before if indicated

e Those patients who attended only Class 1 and who fail to demonstrate adequate

confidence based on SMRT responses andor Total Disturbance are

rescheduled for Class 2

f Patients are scheduled for an Individual Tinnitus Consultation if they attended

both classes and

i Fail to demonstrate adequate confidence indicated by a total SMRT score

of lt 56

ii Respond YES to the question ldquoDo you feel you need further assistance

working with your tinnitusrdquo

g NOTE it is not infrequent that patients will respond they do not feel they need

further assistance working with their tinnitus even though the SMRT and Total

Disturbance suggest otherwise In these cases the veteran is NOT scheduled

for Individual Tinnitus Consultation



Individual Tinnitus Consultation

1 The Individual Tinnitus Consultation varies depending on hearing aid status

2 For aided tinnitus patients optimal amplification must be verified

a These patients should have provided low responses on the 0-10 scale of tinnitus

relief related to hearing aids If their scores were 70 or greater they should have

exited PTM at Level 2 (prior to Level 3 Group Education)

b Please review the hearing aid considerations for tinnitus patients discussed

above

c Different audiologists often have different orientations to hearing aid fittings

especially when it comes to verification of amplification It is therefore typical to

observe substantial differences in fitting paradigms and therefore in fitting

results

d Recommended procedure during the Individual Tinnitus Consultation

i Perform real ear measures to verify current aid performance

ii Adjust the aidsrsquo performance to NALNL1 prescribed gain values

iii NOTE NALNL1 is based on monaural fittings As a result most patients

will remark that while their binaural aids sound good when fit to NALNL1

they are too loud Reducing binaural overall gain by 4 dB usually results

more comfortable loudness and better sound quality When adequate

high-frequency gain cannot be attained gain reduction should be limited

to those frequencies where target was matched

iv After programming adjustments the audiologist should inquire about

tinnitus relief On a scale of 0-10 where 0 means My hearing aids

provide no tinnitus reliefrdquo and 10 means My hearing aids provide

complete tinnitus reliefrdquo how would you rate your tinnitus right now


v In our experience most patients will report far better tinnitus relief if

substantial adjustments were required For most aided tinnitus patients

hearing aid reprogramming is all that is required to facilitate successful

tinnitus management

3 For unaided tinnitus patients completion of any required aspects of the audiologic

evaluation should be completed including ultra-high frequency thresholds For most

ldquonormal-hearingrdquo tinnitus patients (thresholds lt 25 dB HL at 250-8000 Hz) abnormal

thresholds will be observed between 9000-12000 Hz

a Review the patients audiological test results

b Again owing to differences in various audiologistsrsquo orientations to amplification

it is typical to meet with a patient whose hearing is abnormal only at 4kHz and

above or even at 6kHz and above or have abnormal thresholds of only 30-35 dB

in the high frequencies Careful consideration should be given to providing

hearing aids to patients whose hearing levels are normal through 3000 Hz or

whose high-frequency thresholds are 30-35 dB HL given the potential for

significant tinnitus relief with aid use in this population

c

d For those hearing-impaired patients who declined recommended amplification

at the original audiologic evaluation appointment intensive counseling should

be provided to encourage the patient to undergo trial use of amplification since

hearing aid use is the least intensive and often most successful tinnitus

management strategy

e The patients Completed Sound Plans and Changing Thoughts and Feelings

Worksheets are examined reviewed and discussed

i If the patient demonstrates that he or she has not made a good faith

effort to implement the discussed strategies Intensive counseling

inability or unwillingness to at least try the various easy strategies

suggests that the patient likely would not be compliant with either of

more intensive individual treatments (ie Tinnitus Retraining Therapy or

Neuromonics Tinnitus Treatment) each of which requires substantially

greater patient effort


ii If the patient has demonstrated attempts to implement the various

strategies and has not been able to manage the tinnitus successfully

i Review the patientrsquos SMRT responses and provide further review

and directive counseling

1 The underlying causes of tinnitus generation and tinnitus

disturbance (discordant damagedysfunction theory and

neurophysiological model of tinnitus) Relate the patients

audiological results to this discussion

2 Review and creation of additional Sound Plans to manage

tinnitus in different problem situations through systematic

evaluation of different sounds for their effectiveness in

providing tinnitus relief

b Aided patients whose aids have been reprogrammed should be

allowed another use period before further management services

are provided Typically the patient is given a 30-day follow-up

appointment at which time aided tinnitus relief is verified and

additional counseling is provided as appropriate

c Unaided tinnitus patients also may be given additional follow-up

appointment(s) as deemed appropriate

d For all patients additional appointments are considered PTM Level

5 Individualized Management



Individualized Management

The audiologist must determine based on multiple patient-related factors whether or not the

use of specific device-oriented treatment becomes necessary Once the patients individualized

management method has been chosen proceed per the appropriate protocol


Tinnitus Section Atlanta VA Audiology Clinic Case History Form

TINNITUS (RINGING BUZZING OR OTHER EAR OR HEAD NOISES)

Do you have tinnitus __NO TINNITUS __YES-RIGHT EAR ONLY __YES-BOTH EARS __YES-LEFT EAR ONLY

How does it sound __Ringing __Roaring __Hissing __Buzzing __Pulsing __Crickets __Other ___________________________________

When do you hear your tinnitus __ Rarely (0-10 of the time) __ Infrequently (11-25 of the time)

__ Sometimes (26-50 of the time) __ Frequently (51-80 of the time) __ Almost always (81-100 of the time)

IF YOU HAVE TINNITUS MARK THE STATEMENT THAT BEST DESCRIBES YOUR TINNITUS

___ Grade 1 I only notice my tinnitus in quiet environments It does not interfere with

my sleep or with my daily activities Im not really troubled by my tinnitus

___ Grade 2 My tinnitus is easily covered up by background sounds and easily forgotten

during activities It may rarely interfere with my sleep but it does not interfere

with my daily activities or quality of life

___ Grade 3 I hear my tinnitus even in the presence of background sounds but it doesnt

interfere with my daily activities My tinnitus is not quite as noticeable when Im

focused on other activities My tinnitus occasionally interferes with my sleep and

occasionally interferes with quiet activities

___ Grade 4 I hear my tinnitus almost always It is rarely if ever covered up by background

sounds My tinnitus regularly interferes with my sleep and can interfere with my

ability to carry out normal daily activities

___ Grade 5 My tinnitus is always disturbing It is a dominating problem that reduces my

overall quality of life

On a scale of 0 to 10 where 0 means that your tinnitus is not a problem at all and 10 means it is

the worst problem imaginable how do you rate your tinnitus

0 -------- 1 -------- 2 -------- 3 -------- 4 -------- 5 -------- 6 -------- 7-------- 8 -------- 9 -------- 10

Reference

McCombe et al (1999) Guidelines for the grading of tinnitus severity the results of a working

group commissioned by the British Association of Otolaryngologists Head and Neck Surgeons

1999 Clinical Otolaryngology and Allied Sciences Oct 26(5) 388-93


Tinnitus Severity Index

(This form is best completed by the audiologist in an interview format)

Meikle MB Griest SE Stewart BJ Press LS Measuring the negative impact of tinnitus a brief

severity index (1995) Abstracts of the Association for Research in Otolaryngology 1995 167

Never Rarely Sometimes Usually Always

Does your tinnitus make you feel

irritable or nervous 1 2 3 4 5

Does your tinnitus make you feel tired

or stressed 1 2 3 4 5

Does your tinnitus make it difficult for

you to relax 1 2 3 4 5

Does your tinnitus make it

uncomfortable to be in a quiet room 1 2 3 4 5

Does your tinnitus make it difficult to

concentrate 1 2 3 4 5

Does your tinnitus make it harder to

interact pleasantly with others 1 2 3 4 5

Does your tinnitus interfere with your

required activities (work home care or

other responsibilities)

1 2 3 4 5


social activities or other things you do in

your leisure time

1 2 3 4 5


overall enjoyment of life 1 2 3 4 5

How much of an effort is it for you to

ignore your tinnitus when you hear it

1

Can easily

ignore it

2

Some

effort

3

Considerable

effort

4

Can never

ignore it

How much discomfort do you usually

experience when your tinnitus is

present

1

No

discomfort

2

Mild

discomfort

3

Moderate

discomfort

4

A great deal

of

discomfort

Does your tinnitus interfere with sleep 1

No

2

Sometimes

3

Often

4

Always

On a scale of 0 to 10 where 0 means that your tinnitus is not a problem at all and 10 means it is the worst problem

imaginable how do you rate your tinnitus 0 ---- 1 ---- 2 ---- 3 ---- 4 ---- 5 ---- 6 ---- 7---- 8 ---- 9 ---- 10

Circle any factors below that apply (possible etiological or exacerbating factors)

Tinnitus runs in the family High doses of aspirin Ear problems Poor sleep fatigue Diabetes

Quinine or malaria drugs Blood flow condition High stress levels Mental health condition Lupus

Upper respiratory infection High blood pressure Noise exposure Thyroid condition Shingles


Audiological Assessment Progress Note Tinnitus Section

Choices here are Rarely 0-10 of the time Infrequently 11-25 of the time Sometimes 26-50 of the time Frequently 51-70 of the time Most of the time 71-99 of the time Always 100 of the time

Choices here are No apparent need for specific tinnitus services Possible need for specific tinnitus services


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Using Your Bedside Sound Generator

Most tinnitus patients tell us their tinnitus seems louder and more bothersome in silent places like

when they are trying to go to sleep A ticking clock in a sound-filled room sounds softer than the same

ticking clock in a very quiet or silent room In the same way tinnitus will sound softer in a sound-filled

room that in a silent room Your sound generator creates low-level relaxing nature sounds that make it

harder for your brain to detect your tinnitus and this makes it easier for you to relax and fall asleep

There are eight different nature sounds to choose from such as Thunderstorm Lake Shore and Country

Eve You may need to try different sounds to find the one that works best for you You also can add any

number of different overlay sounds such as Seagulls Frogs or Loons to make the nature sound more

realistic The overlay sounds occur randomly without warning If the overlay sounds are startling and not

beneficial turn the overlay sounds off

The sound generator has a one-hour timer we recommend that you DO NOT USE IT Let the device play

all night so that if you wake up you will hear a relaxing nature sound instead of just your tinnitus

Many patients report that using the separate speakers under their personal pillow makes the sound

generator even more helpful The speakers fit into Velcro pockets on the custom pillow cover allowing

the speakers to be removed so the pillow cover can be washed These accessories can be especially

useful if your sleeping partner does not want to hear the nature sounds

Remember the sound generator is designed to create LOW-LEVEL relaxing nature sounds The volume

of the nature sounds should never be turned up so loud that they actually cover up your tinnitus

How Do I Use the Different Parts of My Sound Generator Kit

Your kit comes with stereo pillow speakers an extension cord for the speakers and a battery pack These

items help you get the most use out of the sound generator For bedtime use set the sound generator

on your bedside table and plug the power cord and stereo speakers into the correct jacks on the back of

the device

The battery pack lets you move the sound generator to other places without climbing behind your bed

to unplug the first power cord Simply unplug the power cord and stereo speakers from the back of the

sound generator and carry it to any location where you wish to listen to it (such as your desk your

favorite recliner or for travel) Then plug the battery pack into the back of the sound generator in the

other location

Use the extension cord for earbuds if you need them You can easily return your sound generator to

your bedside by just plugging it back in to the other cords

You can use any headphones or earbuds that have a 18rdquo headphone jack with your bedside sound

generator as well Also you can plug your pillow speakers into any sound device with a standard 18rdquo

headphone jack such as a mp3 player a portable CD player or your cell phone) so you can enjoy other

soothing sounds


Helpful Tinnitus Information

What is Tinnitus

Tinnitus is the medical term for the perception of sound in one or both ears or in the head when no external sound is present It is often referred to as ringing in the ears although some people hear hissing roaring whistling chirping or clicking Tinnitus can be intermittent or constant-with single or multiple tones-and its perceived volume can range from subtle to shattering

How many people have tinnitus

The ATA estimates that over 50 million Americans experience tinnitus to some degree Of these about 12 million have severe enough tinnitus to seek medical attention And about two million patients are so seriously debilitated that they cannot function on a normal day-to-day basis I have heard two different pronunciations Which is correct

Tinnitus has two pronunciations tin-NIGHT-us or TIN-it-us Both are correct though the

American Tinnitus Association uses tin-NIGHT-us The word comes from Latin and means to

tinkle or to ring like a bell

What causes tinnitus

The exact physiological cause or causes of tinnitus are not known There are however several

likely sources all of which are known to trigger or worsen tinnitus

Noise-induced hearing loss - Exposure to loud noises can damage and even destroy hair

cells called cilia in the inner ear Once damaged these hair cells cannot be renewed or

replaced Hearing loss can also be caused by excessive noise exposure Coincidentally

up to 90 of all tinnitus patients have some level of hearing loss

Wax build-up in the ear canal - The amount of wax ears produce varies by individual

Sometimes people produce enough wax that their hearing can be compromised or their

tinnitus can seem louder If you produce a lot of earwax speak to your physician about

having excess wax removed manually - not with a cotton swab but by a qualified health

care professional

Certain medications - Some medications are ototoxic-that is the medications are toxic

to the ear Other medications will produce tinnitus as a side effect without damaging

the inner ear Effects which can depend on the dosage of the medication can be

temporary or permanent Before taking any medication make sure that your prescribing

physician is aware of your tinnitus and discuss alternative medications that may be

available


Ear or sinus infections - Many people including children experience tinnitus along with

an ear or sinus infection Generally the tinnitus will lessen and gradually go away once

the infection is healed

Jaw misalignment - Some people have misaligned jaw joints or jaw muscles which can

not only induce tinnitus but also affect cranial muscles and nerves and shock absorbers

in the jaw joint Many dentists specialize in this temporomandibular jaw misalignment

and can provide assistance with treatment

Cardiovascular disease - Approximately 3 percent of tinnitus patients experience

pulsatile tinnitus people with pulsatile tinnitus typically hear a rhythmic pulsing often

in time with a heartbeat Pulsatile tinnitus can indicate the presence of a vascular

condition-where the blood flow through veins and arteries is compromised-like a heart

murmur hypertension or hardening of the arteries

Certain types of tumors - Very rarely people have a benign and slow-growing tumor on

their auditory vestibular or facial nerves These tumors can cause tinnitus deafness

facial paralysis and loss of balance

Head and neck trauma - Physical trauma to the head and neck can induce tinnitus Other

symptoms include headaches vertigo and memory loss

Certain disorders - such as hypo- or hyper-thyroidism lyme disease fibromyalgia and

thoracic outlet syndrome can have tinnitus as a symptom When tinnitus is a symptom

of another disorder treating the disorder can help alleviate the tinnitus

Do children get tinnitus

Tinnitus does not discriminate people of all ages experience tinnitus However tinnitus is not a

common complaint from children Children with tinnitus are less likely than adults to report

their experience in part because children with tinnitus are statistically more likely to have been

born with hearing loss They may not notice or be bothered by their tinnitus because they have

experienced it their entire lives

Children like people of all ages can be at risk for tinnitus if they are exposed to loud noises

Recreational events like fairs or car races or sports games can all include high-decibels activities

that can damage kids ears Hearing protection is always recommended as is a discussion about

the danger of loud noises and the choices kids have to turn it down or walk away


My neighborrsquos tinnitus doesnt bother her Mine drives me nuts Why the difference

Approximately 50 million Americans experience tinnitus but not everyone experiences it to the

same degree Some people hear ringing or other noises in their ears immediately following

exposure to excessive noise like right after a concert but the sound is temporary Other people

report hearing a slight noise all the time if they listen for it but most of the time cannot

distinguish the noise over all the other sounds in their environment Other factors can affect

the severity of the condition from patient to patient such as different degrees of hearing loss

and different kinds of noises heard Interestingly the loudness of the tinnitus when measured

in a laboratory setting did not correlate to the severity of the tinnitus as rated by the patients

themselves Every person has his or her own level of tolerance to the tinnitus sounds It is a

very personal and individual experience

Is tinnitus hereditary

There appears to be a predisposition based on heredity for some people when they are

exposed to loud sounds but whether or not tinnitus is genetically indicated is not certain

Scientists working on the Human Genome Project for example have not discovered a tinnitus

gene but they have identified genes that are responsible for a few rare varieties of hearing

loss temporomandibular joint (TMJ) dysfunction Meacuteniegraveres Disease and acoustic Neuroma

These conditions frequently include tinnitus as a side effect which suggests that there might be

a connection For now however a connection between your mothers tinnitus and your

tinnitus is still unknown

Can a one-time exposure to loud noise cause tinnitus

Many people write to the American Tinnitus Association asking if a one-time exposure to loud

noise experienced many years ago can cause tinnitus Noise is damaging if you must shout to be

heard if your ears hurt or if your hearing is lessened immediately following noise exposure

The noise exposure could occur just one time or over months or years The level of noise can

affect the degree of hearing loss For example sounds of 100 decibels experienced for more

than 15 minutes can cause hearing loss Sounds of 110 decibels experiences for more than a

minute can cause hearing loss

A one-time exposure to loud noise is not guaranteed to cause tinnitus or permanent hearing

loss since peoples ears vary in sensitivity It is also possible that the damage from noise

exposure might not be noticeable for many years


Does tinnitus cause depression

In some cases yes The chronic sound of tinnitus can cause difficulty with sleep concentration

reading interpersonal relationships and other everyday activities ndash all of which can lead a

person especially one who is predisposed to it towards a state of depression

In a 2003 study on depression and tinnitus researchers found that most people with tinnitus

were neither depressed nor seriously bothered by their tinnitus But the patients who were

depressed were far more disabled by their tinnitus than the non-depressed patients If

depression is a problem for you it would be wise to seek help from a mental health

professional

Is there anything I can do to protect myself from tinnitus

First protect your hearing At work make sure Occupational Safety amp Health Administration

(OSHA) regulations are met hearing protection is required under OSHA for any job in which

noise levels exceed 90 decibels over the course of an eight-hour workday Many hearing

specialists counsel that this sound level is too high and for some people 90 decibels is still too

loud Further as noise levels increase the recommended time of exposure decreases OSHA

mandates that workplaces with excessive noise levels must protect workers by implementing a

continuing effective hearing conservation program In other words wear your earplugs or

earmuffs limit the amount of time you spend in noisy environments and follow hearing

conservation guidelines established by your employer

Recreational noise also has an impact on your hearing The next time you are around a noise

that bothers your earsmdashfor example a sporting event concert or while huntingmdashwear hearing

protection which can reduce noise levels 15 to 20 decibels For extremely loud situations

earmuffs over earplugs might be necessary Be aware of other activities or situations that

include loud noises like hair drying or lawn-mowing Make it easy for yourself to protect your

ears by hanging earmuffs over the lawn mower handle Repeated exposure to loud noises can

have a cumulative damaging effect on your hearing

If your physician prescribes you medications be sure to ask if the prescribed medications are

ototoxic or harmful to the ears or if the drugs are associated with tinnitus as a side effect This

information is easily obtained in the Physicians Desk Reference


Frequently Asked Questions About Tinnitus

1 Can anything make tinnitus worse

Exposure to loud noises as mentioned earlier can have a negative effect on your hearing and

exacerbate tinnitus Be sure to protect yourself with earplugs earmuffs or by simply not taking

part in noisy events

Some medications can make tinnitus worse Tell all of your physiciansmdashnot just your ear nose

and throat doctormdashabout all prescription and over the counter medications you are currently

taking or have recently taken

Many people find that alcohol nicotine and caffeine can worsen their tinnitus as can eating

certain foods Some people find that foods with a high sugar content or any amount of quinine

(tonic water) make their tinnitus seem louder Monitor how you respond to different stimuli

and find a healthy balance where you do not eliminate all the foods that you love but also

where you do not unnecessarily exacerbate your tinnitus

Finally stress and fatigue can affect your tinnitus Make time to relax and understand that life

events can manifest themselves in your body in the form of increased tinnitus Of course this is

easier said than done Finding a good support network can help

What kinds of drugs are available to treat tinnitus

There is no drug on the market designed specifically for tinnitus treatment There are however

several medications that have provided many tinnitus patients with relief But they are not

without their own caveats For example some medications that can help tinnitus are also habit

forming and should only be used when under the care of a physician who understands tinnitus

The ATA has more information about various medications that can help although ATA staff

cannot recommend medications The ATA also distributes a list -- compiled by the Physicians

Desk Reference -- of medications that can cause tinnitus This listing is available by calling the

ATA at (800) 634-8978 We do not have copyright permission to make this listing available

online


What does loud mean

We measure the loudness of sound in decibels (dB) Most experts recommend that you use

earplugs when exposed to 85 dB and above But what does 85 dB mean The following chart

shows common sounds and their associated sound levels

20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine

Alarm clock (two feet away)

85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI

Blow dryer subway train

Power mower chainsaw

Screaming child

Rock concert thunderclap

Jackhammer jet engine plane (100 feet away)

Noisy workplaces

The National Institute for Occupational Safety and Health (NIOSH) ndash an arm of the Centers for

Disease Control and Prevention ndash says that workers and others in loud environments should not

be exposed to sounds over 85 dB over an eight-hour period

Noise-induced hearing loss (NIHL)

For many people tinnitus is a symptom of hearing loss More than 90 percent of American

Tinnitus Association members with tinnitus also report some hearing loss For many loss is at

the higher frequencies which is often induced by exposure to loud noise

Noise-induced hearing loss can be caused by a one-time exposure to a loud sound or by

repeated exposure to sounds over an extended period of time You cannot toughen up your

hearing by regularly listening to loud noises

Healthy hearing habits can help prevent hearing loss and tinnitus However the effects of loud

noises can worsen existing tinnitus and further degrade hearing If you already have one or

both of these conditions protect your ears from further damage If you do not have them learn

how to protect your hearing

How damage occurs

Sounds of less than 80 dB even after long exposure are unlikely to cause hearing loss Its

impossible to predict how individuals respond to loud noises ndash each personrsquos sensitivity to

sound is different However we know that exposure to a one-time-only or continuous noise can

cause temporary hearing loss If hearing recovers this temporary loss is called temporary

threshold shift which typically disappears 16 to 48 hours after exposure


Hearing loss can also be permanent if loud sounds damage or destroy the delicate ear cells in

your inner ear called cilia Once these cells are damaged or destroyed they cannot be repaired

Research into regenerating inner ear cells is underway but has not yet advanced to the

treatment stage

When you need hearing protection

This is the standard recommendation use earplugs earmuffs or other protection devices

when exposed to sounds above 85 dB You probably donrsquot have a sound meter with you to test

decibel levels everywhere you go so you canrsquot always be sure when your environment is too

loud In general if you are standing three feet away from someone and cannot hear what they

are saying the noise level could be damaging your hearing

How loud is too loud mdash an interactive Web site

Check out Dangerous Decibels a great Web site for kids and adults alike that tests your

knowledge of noise risk and just how loud sounds in our everyday lives can be Hint click on the

sitersquos ldquoVirtual Exhibitrdquo and have some fun

MP3 players iPods amp your ears

One in three teens owns an MP3 player or iPod Can listening to loud music with these personal

players damage their hearing YES and that can result in tinnitus

Hearing conservation tips

In general if you are standing three feet away from someone and cannot hear what they are

saying the noise level could be damaging your hearing Hearing conservation means protecting

your ears from excessively loud sounds

Walk away from loud noises

Turn down the volume

Limit the intensity of the noise by not standing directly near its source

Limit the time you expose your ears to loud noises

Wear earplugs when yoursquore around sounds of 85 dB and above Disposable foam

earplugs are inexpensive easy to insert and effective

Turn down your CDcassette player stereo or iPod

Cross the street when you hear someone operating a leaf blower


Wear earplugs at concertsgo to the back of the nightclub or outside to give your ears a

break

Cover your ears with your hands when yoursquore walking past a jackhammer

About earplugs

Keep a clean pair handy in your purse backpack wallet or pocket

Wear earplugs during the trailers at the movies ndash their volume is typically cranked up

Ask the manager at the movie theater to turn the volume down if it is too loud Theater

staff will very often comply with this request

Wear earplugs at amusement parks and concerts Earplugs cut out just 15-20 dB so

youll still be able to hear

Wear earplugs or protective earmuffs when using power devices eg lawn mower

tool vacuum and other noisy household appliances

Read the labels for noise levels on appliances childrens toys and any product that

generates sound

Learning to Manage Tinnitus Learning to manage your tinnitus takes time People who follow the techniques described

below habituate to their tinnitus To the point where they are not emotionally disturbed by it

and they can lead full and productive lives The fundamentals of learning to manage your

tinnitus are based on 4 steps that will be explained more fully in this section

1 Overcoming your underlying fears of tinnitus

When you first get tinnitus it is common to have many fears regarding your tinnitus such as

Do I have a serious illness brain tumor or blood clot

Although 96 of all tinnitus sufferers have no treatable medical condition causing the

tinnitus it is important that this possibility be eliminated by a thorough examination by

your General Practitioner and an ENT (Ear Nose and Throat) Specialist

Will my tinnitus drive me insane

There have been no reported cases of tinnitus causing insanity

Will it get louder

Generally not


Will it continue forever

Although there are cases where tinnitus has spontaneously disappeared it is the

exception rather than the rule It is best to assume that you have it for the longer term

and learn to manage it

It cant be cured

There are many researchers that are working on more fully understanding tinnitus

however do not live in hope of a miracle cure Learn to manage it and get on with your

life

I will have no more peace and quiet

Very rarely do we have absolute quiet Most times there are ambient and

environmental noises around us Being in an absolutely quiet environment is unnatural

for humans You still able to enjoy peace and tranquility

It will interfere with my concentration

The ability to concentrate will improve over time as you habituate to the tinnitus

2 Having the Correct Perception of your Tinnitus

Orr brain takes in sounds and classifies them according to whether they are threatening

neutral or non-threatening sounds When the conscious mind classifies these sounds the sub

conscious mind has an automatic reaction to the sound the next time it is heard This pattern

will continue unless the conscious mind re-classifies the sound

When the conscious mind first hears tinnitus it cannot correlate the sound with anything that it

has heard so our survival instincts means the brain will classify it as possibly threatening and

will place the body and mind in a state of high alert for possible fight or flight

If the conscious mind maintains that perception of tinnitus each time that you hear your

tinnitus the sub-conscious mind will put your body and mind into a state of high anxiety which

no person or animal can maintain for long without becoming dysfunctional

It is therefore crucial that you perceive tinnitus as it truly is

ie non-threatening Although it is annoying it cannot

harm you in any way The objective for any tinnitus

sufferer is to habituate to the tinnitus If you perceive

tinnitus as threatening you are in a vicious cycle of stress

and anxiety as illustrated by the following example and

you cannot habituate to your tinnitus


3 The Importance of Not Focusing on your Tinnitus

The more a person focuses on their tinnitus the louder it will appear and the more distressed

they will become One of the critical aspects of learning to manage your tinnitus is shifting your

focus from the tinnitus to something more pleasurable This can be an activity such as walking

gardening reading (although this can be difficult in the early stages) listening to relaxing music

or any activity that you enjoy that absorbs your mind

An example of how this works is the case of a small child that falls over and grazes its knee The

child runs crying and distressed to its mother After inspecting the knee and giving the child a

hug the mother will ask whether the child would like a chocolate biscuit the child stops crying

and the pain of the grazed knee disappears as the focus of the childs mind is shifted from the

knee to the chocolate biscuit

It is worthwhile writing down the things that you enjoy doing so that when your tinnitus is bad

you can mentally refer to this list and do one or more of the activities that you have identified

as likely to shift your focus from the tinnitus In the early stages shifting your focus is not always

easy It takes practice and perseverance As you become better at it you will notice that there

are more and longer periods each day when you become aware that you have not been

listening to your tinnitus and you are on the way to successful management and habituation to

your tinnitus

4 Adjusting your Lifestyle

The anecdotal evidence of a link between stress and the exacerbation of tinnitus is very strong

It is therefore important that you reduce the amount of stress in your life whenever possible

Although stress is a part of everyday life recognizing those periods of stress and being

proactive about reducing the stress levels by undertaking relaxation therapies is important in

managing your tinnitus

Exposure to loud noise

Loud noise will exacerbate tinnitus Ear muffs or ear-plugs should be worn when activities such

as mowing the lawn or using a chainsaw are undertaken Venues such as nightclubs or

entertainment venues that have excessively loud noise should be avoided or ear protection

used If you have to shout to make yourself heard by someone standing within 1 to 15 meters

of you the noise level is considered excessive and it will exacerbate your tinnitus


Excessive use of alcohol or recreational drugs

Different peoples tinnitus reacts to different stimuli Some of the more common everyday

products that cause a temporary increase in tinnitus when used in excess are caffeine

(chocolate cola drinks coffee - more than 6 cups per day) red wine nicotine and spicy foods

Many prescription and non-prescription drugs also exacerbate tinnitus When your doctor

prescribes a drug for you ask them to check whether the drug has a side effect of tinnitus If it

has ask whether there is an alternative that could be used It is also worth noting when your

tinnitus is more troublesome whether you have had anything unusual in your diet that may

have caused the increase That is not to say that you should avoid those items altogether Just

be aware that they may cause a temporary increase in your tinnitus Living with tinnitus is

difficult enough without giving up things that you enjoy


Environmental Sound Enrichment Jonathan Hazell Director Tinnitus and Hyperacusis Centre London

Tinnitus frequently emerges in quiet places The auditory system evolved in the presence of

continuous nature sound Silence is unnatural and associated with danger and evokes a warning

response Environmental sound enrichment is required 24 hours a day with non-stimulating

sounds that are pleasant and never result in an aversive reaction

Modern sound environments versus nature

In nature there is a continuous background of nature sounds Silence is a warning signal

usually indicating the arrival of a predator In modern society we have constructed solid

buildings which exclude sound and are often double-glazed to reduce heat-loss This means

that the rooms we live and work in can have very low levels of natural back ground noise

particularly at night

In many countries especially in the west there is a tendency for smaller social units with more

people particularly older people living alone in very quiet surroundings The ready availability

of earplugs means that they are often used not just to protect the ear from damage but also

to avoid hearing any sounds particularly at night With an increasing number of older people in

our populations there are many more with varying degrees of hearing loss Proper use of

hearing aids is far below what is needed and this has the effect of imposing relative silence as

well

One feature of our western culture is the way in which silence is imposed in childhood We are

told be quiet when we go to bed do your homework etc It is during these times that

childhood tinnitus emerges as well as the development of behavioral patterns for seeking

silence in adult life We even have the saying lsquoSilence is goldenrsquo It is NOT

Effects of reduced environmental sound

Tinnitus is experienced by anyone who listens carefully in a quiet room for 5 minutes Most of

us do this every night of our life when we retire to a quiet study lounge or bedroom It is

perhaps surprising that we can do this for so many years without having any experience of

tinnitus Animal experiments have shown us that the auditory system itself increases in

sensitivity when background noise drops below a certain level resulting in increased gain or

amplification of external sounds This means that there is more chance of picking up very weak

sounds in silence rather than in enriched environments


Loudness of any sound depends on the contrast between the signal and any background noise

Consider listening to a car radio on the motorway with the volume up at a comfortable

listening level and then driving onto a quiet side road or a garage The radio can then cause

loudness discomfort for a normal listener In silence the loudness of even quiet sounds may be

perceived as very loud particularly if they have strong meaning (eg a burglar alarm at night

200 yards down the street) For the same reason tinnitus will sound very loud if there is no

other sound in the environment (no enrichment) In silence the attention focus of the brain can

only be directed to the one sound that is present tinnitus There is no possibility of not hearing

it

Changes in the auditory system can only occur if it is being stimulated with sound These

changes are necessary for the habituation (or blocking) of intrusive external sounds and

tinnitus Plasticity (the ability to change or reprogram) is reduced by silence Reduced

stimulation of hearing nerve connections such as without amplification or as a result to an

aversive reaction to sound results in habituation being slowed down significantly

These effects continue during sleep The cortex is in a low state of activity in sleep so we have

no conscious awareness of ourselves or our environment However at this time subconscious

pathways and auditory filters needed for selective hearing function normally The failure to

enrich our sound environment during sleep means the effectiveness of sound stimulation in

increasing plasticity is reduced by at least one third

Reasons for seeking silence

There are many reasons why we have a natural tendency to seek silence Many people try to

live in a silent world because of the dislike of unwanted unannounced visitors or a telephone

call or the sounds of a noisy city The belief is no sound = no intrusion However the quieter it

becomes the more easily we can hear softer and further-away sounds which in turn results in

a greater need for greater protection from even these soft sounds Silence may be considered

by many to be peaceful and relaxing but our autonomic nervous system activity actually

increases in silence getting us ready for the possibility of predator attack The best

environment for relaxation is one enriched by nature sounds

It is common to develop quite strong views about what is acceptable in terms of other people

making noise Decreased tolerance for sound is often considered normal behavior The dislike

for ordinary everyday sounds is much more common in patients with tinnitus and indeed 40

have pre-existing sound sensitivity


Normality of environmental sound enrichment

The art of sound enrichment is very old and found in many ancient civilizations most notably

perhaps in Japan where waterfalls fountains and wind chimes have always been a part of

architecture and landscaping A very important job in Japan is that of the waterfall tuner

Most people find that the sounds of nature are enjoyable and relaxing Being in the garden or

on the beach is for most people a relaxing experience Even tinnitus and hyperacusis patients

find these places peaceful and often report that tinnitus disappears completely when they are

on vacation The sounds of rain can be soothing and calming and generally is not intrusive in

the way that man-made sounds may be

Part of the reason for this is that our hearing system developed in a sound-rich environment

with nature sounds always present It is only over the last few hundred years that buildings

have effectively excluded nature sounds

Sleep is a problem for many people Sound enrichment improves sleep quality in everyone and

it for this reason that devices simulating the sounds of nature or CDs with recordings of nature

sounds are being sold widely for this purpose

Types of sound enrichment

Perhaps the best natural sound enrichment is nature itself For country-dwellers it may be

possible to have the window open all the time otherwise it is important to create sounds

inside the home where we spend the majority of our time In the past household equipment

has been recommended as a simple available sound source such as large fans fish tanks etc

Where these sounds are a normal part of the home environment they can be helpful but the

volume is not easy to control Water features are excellent such as indoor and outdoor

fountains and waterfalls which are widely available The sounds of water are particularly liked

and well tolerated

Radios TV and music should be used only when they are part of normal recreation when you

normally would listen to them Just leaving these devises on all the time as sound enrichment is

not recommended All music and speech has meaning and thus they stimulate the autonomic

system at a time when we are trying to reduce reactivity The use of quality equipment for

presenting any sound enrichment ensures good quality and realistic sounds which will be more

relaxing


We encourage the use of sound generators which have a selection of electronically reproduced

nature sounds These devices are much easier to control to move about or even to take away

on trips CDs and tapes of nature sounds are useful but the content may vary and change

making them attention-seeking and therefore less effective and less relaxing All sound

enrichment should be continuous and not just used for a short period such as just for getting

to sleep instead leave the device on all night

Features and requirements of sound enrichment

Sound enrichment should not mask or cover up your tinnitus Habituation cannot occur to a

sound you cannot hear When you first turn on your sound source check that you can still hear

your tinnitus and that is hasnrsquot altered or changed If you have a hearing loss then test them

with your hearing aids turned to their normal listening setting

It is essential that any sound enrichment never produces any aversion dislike or results in

increased arousal Introducing a new sound into the environment that evokes a negative

reaction will simply make matters worse It may take some time and experimentation to find

the sound that you like that that produces relaxation It is also important that the family should

also find the sounds pleasant and non-intrusive Usually this is not a problem since family

members realize the importance of this part of treatment and usually understand that sound

enrichment is good for everyone

Sound enrichment should be used 24 hours a day particularly at night Not using sound

enrichment at night reduces the effectiveness of treatment by at least one third (the time you

are asleep) Because the parts of the hearing mechanism that are important in tinnitus

management are lsquoawakersquo during sleep sound enrichment should always be used at this time It

is a good idea to leave the sound enrichment source on at all times in the bedroom so that it

becomes a part of the bedroom furniture For those who have a hearing impairment and a

partner who cannot tolerate the sound enrichment a pillow speaker can be very valuable

The benefits of sound enrichment

Many patients experience an immediate reduction in tinnitus intrusiveness and severity with

sound enrichment although this is a very individual response Soon there should be improved

sleep and reduced wakefulness Environmental sounds will be less intrusive Sound enrichment

produces an overall reduction in activity in the autonomic nervous system Autonomic nervous

system activity levels are high in patients with tinnitus - sound enrichment helps to reduce this

overall high level of activity Sound enrichment also reduces the contrast between or tinnitus

and the background and therefore reduces the perceived loudness of tinnitus


Helpful Hints for Better Sleep

Poor sleep habits are among the most common problems encountered in our society We stay

up too late and get up too early We interrupt our sleep with drugs chemicals and work and

we over-stimulate ourselves with late-night activities such as television Below are some

essentials of good sleep habits Many of these points will seem like common sense But it is

surprising how many of these important points are ignored by many of us Click on any of the

links below for more information

Your Personal Habits

Fix a bedtime and an awakening time Do not be one of those people who allow

bedtime and awakening time to drift The body gets used to falling asleep at a certain

time but only if this is relatively fixed Even if you are retired or not working this is an

essential component of good sleeping habits

Avoid napping during the day If you nap throughout the day it is no wonder that you

will not be able to sleep at night The late afternoon for most people is a sleepy time

Many people will take a nap at that time This is generally not a bad thing to do

provided you limit the nap to 30-45 minutes and can sleep well at night

Avoid alcohol 4-6 hours before bedtime Many people believe that alcohol helps them

sleep While alcohol has an immediate sleep-inducing effect a few hours later as the

alcohol levels in your blood start to fall there is a stimulant or wake-up effect

Avoid caffeine 4-6 hours before bedtime This includes caffeinated beverages such as

coffee tea and many sodas as well as chocolate so be careful

Avoid heavy spicy or sugary foods 4-6 hours before bedtime These can affect your

ability to stay asleep

Exercise regularly but not right before bed Regular exercise particularly in the

afternoon can help deepen sleep Strenuous exercise within the 2 hours before

bedtime however can decrease your ability to fall asleep

Your Sleeping Environment

Use comfortable bedding Uncomfortable bedding can prevent good sleep Evaluate

whether or not this is a source of your problem and make appropriate changes


Find a comfortable temperature setting for sleeping and keep the room well

ventilated If your bedroom is too cold or too hot it can keep you awake A cool (not

cold) bedroom is often the most conducive to sleep

Block out all distracting noise and eliminate as much light as possible

Reserve the bed for sleep and sex Dont use the bed as an office workroom or

recreation room Let your body know that the bed is associated with sleeping

Getting Ready For Bed

Try a light snack before bed Warm milk and foods high in the amino acid tryptophan

such as bananas may help you to sleep

Practice relaxation techniques before bed Relaxation techniques such as yoga deep

breathing and others may help relieve anxiety and reduce muscle tension

Dont take your worries to bed Leave your worries about job school daily life etc

behind when you go to bed Some people find it useful to assign a worry period during

the evening or late afternoon to deal with these issues

Establish a pre-sleep ritual Pre-sleep rituals such as a warm bath or a few minutes of

reading can help you sleep

Get into your favorite sleeping position If you dont fall asleep within 15-30 minutes

get up go into another room and read until sleepy

Getting Up in the Middle of the Night

Most people wake up one or two times a night for various reasons If you find that you get up in

the middle of night and cannot get back to sleep within 15-20 minutes then do not remain in

the bed trying hard to sleep Get out of bed Leave the bedroom Read have a light snack do

some quiet activity or take a bath You will generally find that you can get back to sleep 20

minutes or so later Do not perform challenging or engaging activity such as office work

housework etc Do not watch television

A Word about Television

Many people fall asleep with the television on in their room Watching television before

bedtime is often a bad idea Television is a very engaging medium that tends to keep people up

We generally recommend that the television not be in the bedroom At the appropriate

bedtime the TV should be turned off and the patient should go to bed Some people find that

the radio helps them go to sleep Since radio is a less engaging medium than TV this is probably

a good idea


Other Factors

Several physical factors are known to upset sleep These include arthritis acid

reflux with heartburn and headaches

Psychological and mental health problems like depression anxiety and stress are

often associated with sleeping difficulty In many cases difficulty staying asleep

may be the only presenting sign of depression A physician should be consulted

about these issues to help determine the problem and the best treatment

Many medications can cause sleeplessness as a side effect Ask your doctor or

pharmacist if medications you are taking can lead to sleeplessness

To help overall improvement in sleep patterns your doctor may prescribe sleep

medications for short-term relief of a sleep problem The decision to take sleeping

aids is a medical one to be made in the context of your overall health picture

Always follow the advice of your physician and other healthcare professionals The

goal is to rediscover how to sleep naturally


Examples Factory First-Fit NAL-NL1 Algorithm vs REM NALNL1


Speech-Mapping vs Real-Ear Measures


Custom Clinic Hearing Aid Questionnaire



Hearing AidTinnitus Questionnaire

Progress Note Addendum

S

A completed survey evaluating the outcome of the veterans

recent hearing aid fitting was received today

OA

The outcome survey consisted of three parts

1 The International Outcomes Inventory for Hearing Aids (IOI-HA

Cox Hyde amp Gatehouse 2000) a valid and reliable tool

consisting of seven questions using a 5-point rating scale

The IOI-HA was designed to assess benefit satisfaction and

quality-of-life changes associated with hearing aid use

Veterans responses to the IOI-HA were compared to normative

values (Cox Alexander amp Beyer 2003)

------------------------------------------------------------------

QUESTION NORM VETERANS SCORE

------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4

3 Residual Activity Limitation 2-4

4 Satisfaction 2-5

5 Residual Participation Restriction 3-4

6 Impact on Others 2-5

7 Quality of Life 3-4

8 Difficulty Without Aid na

------------------------------------------------------------------

Veterans responses to all items are within the normative range

No further actions related to IOI-HA responses are necessary at

this time


with the exception of _

Further actions related to the veterans IOI-HA responses may be

warranted to improve treatment outcome

2 Other factors contributing to successful aid use including

practical issues related to physical comfort sound quality and

communication success in different sound environments Veterans

responses indicated

appropriate adjustment to the new aids veteran denied any

desire for a follow-up appointment at this time

specific practical issue(s) impacting successful use of the

hearing aids that may warrant further actions _


3 Assessment of possible tinnitus relief provided by the hearing aids

On a scale of 0 to 10 where 0 means the hearing aids provide no relief from

the tinnitus and 10 means the hearing aids provide complete relief veteran

rated the tinnitus relief from his hearing aids as _ indicating the aids are

providing adequate inadequate relief from the tinnitus

Patients who report minimal tinnitus relief may require further tinnitus

services and may benefit from attending Tinnitus Group Education

P

Veteran to contact clinic for hearing aid assistance as needed

Veteran declined offer of appointment for hearing aid adjustment

Need for Tinnitus Group Education will be assessed at that

appointment

Veteran was scheduled for Tinnitus Group Education

Veteran was scheduled for a HEALTH TECH SUPPORT appointment on a

routine basis within 30 days

The veteran was scheduled for a hearing aid fitting follow-up

appointment on a routine basis within the next 60 days to address

factors resulting in unsuccessful hearing aid treatment outcome


Why Should I Attend the Tinnitus Classes

The Tinnitus Classes help veterans manage their tinnitus successfully Each of the two Tinnitus

Classes class is two hours long Please make sure you can stay for the entire length of each class by

double-checking for any conflicts (such as your VA appointments) If you have some a conflict and

will not be able to stay for the entire class you will not get the results you need If this happens

please reschedule the classes You must attend Class 1 first and then Class 2

Class 1

Tinnitus Class 1 is two-hour program that helps veterans learn the main theories about what

causes of tinnitus why it can be so disturbing and annoying and how to use different types of sound

to get your tinnitus under control so it doesnt control you You will learn

How to use Interesting Sound to help direct your attention away from the tinnitus

How to use Soothing Sound to experience relief from anxiety tension and stress that

causes or is caused by your tinnitus

How to use Background Sound to make it harder for your brain to detect your tinnitus

You will learn how to create effective Sound Plans to figure out which sounds work best for you for

specific problem situations Also you will learn relaxation techniques to reduce stress and tension

associated with your tinnitus You will receive the Managing Your Tinnitus workbook and handouts

of all of the Tinnitus Class materials for review and use at home The workbook includes a DVD of all

the material presented for reviewing at home along with a CD of different types of interesting

soothing (relaxing) and background sounds for you to try out Additionally you will receive a list of

internet resources for free music nature sounds guided relaxation guided imagery and other

sounds to help you get your tinnitus under control so it doesnt control you

Class 2

Tinnitus Class 2 also is a two-hour program that builds on the information given in Class 1 You

must attend Class 1 first and then Class 2 We will briefly review the information you learned in

Class 1 and we will review your Sound Plans and how they worked for you Then you will learn

new information about changing your reactions to tinnitus and changing your thoughts about

tinnitus More information is provided about relaxation techniques and we will talk about other

ways to direct your attention away from your tinnitus Our goal is to help you control your tinnitus

so it doesnrsquot control you

How Will the Tinnitus Classes Help Me

After attending both Tinnitus Classes most veterans find that they feel less stressed about tinnitus

almost never think about tinnitus feel like tinnitus is not much of a problem and feel like there is no

need for further help with their tinnitus


Tinnitus Functional Index

Meikle et al (2012) The tinnitus functional index development of a new clinical measure for chronic

intrusive tinnitus Ear and Hearing Mar-Apr33(2)153-76



Patient Health Questionnaire (PHQ-9) Kroenke K Spitzer R Williams J (2001) The PHQ-9 Validity of a Brief Depression Severity Measure Journal of

General Internal Medicine 16(9) 606-613


Tinnitus Reaction Questionnaire (TRQ) Wilson P Henry J Bowen M and Haralambous G (1991) Tinnitus Reaction Questionnaire Psychometric properties of a measure of distress associated with tinnitus Journal of Speech and Hearing Research 34 197-201

Percentage of time you were awake that you were AWARE of your tinnitus _______ Percentage of time that you HEAR your tinnitus that it DISTURBS you _______

This questionnaire is designed to find out what sort of effects tinnitus has had on your lifestyle general well-being etc Some of the effects below may apply to you and some may not Please answer ALL questions by circling the number that best reflects how your tinnitus has affected you OVER THE PAST WEEK

Not

at all

A little of the time

Some of the time

A good deal of

the time

Almost all of

the time

1 My tinnitus has made me unhappy

2 My tinnitus has made me feel tense

3 My tinnitus has made me feel irritable

4 My tinnitus has made me feel angry

5 My tinnitus has led me to cry

6 My tinnitus has led me to avoid quiet situations

7 My tinnitus has made me less interested in going out

8 My tinnitus has made me depressed

9 My tinnitus has made me feel annoyed

10 My tinnitus has made me confused

11 My tinnitus has driven me crazy

12 My tinnitus has interfered with my enjoyment of life

13 My tinnitus had made it hard for me to concentrate

14 My tinnitus has made it hard for me to relax

15 My tinnitus has made me feel distressed

16 My tinnitus has made me feel helpless

17 My tinnitus has made me feel frustrated with things

18 My tinnitus has interfered with my ability to work

19 My tinnitus has led me to despair

20 My tinnitus has led me to avoid noisy situations

21 My tinnitus has led me to avoid social situations

22 My tinnitus has made me feel hopeless about the future

23 My tinnitus has interfered with my sleep

24 My tinnitus has led me to think about suicide

25 My tinnitus has made me feel panicky

26 My tinnitus has made me feel tormented


Suicide Risk Flag


Tinnitus-Hearing Survey (Henry et al 2008)

Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem

Over the last week I couldnrsquot

understand what others were saying

in noisy or crowded places


understand what people were saying

on TV or movies

Over the past week I couldnrsquot

understand people with soft voices


understand what was being said in

group conversations

Over the last week tinnitus kept me

from sleeping


from concentrating on reading


from relaxing

Over the last week I couldnrsquot get my

mind off my tinnitus

Over the last week every day sounds

were too loud for me

Being in a meeting with 5 to 10

people would be too loud for me


For a Number of Internet Sound Resources Please Visit

httpwwwSteveBentonAuDweeblycom


Tinnitus Group Education Class 1 Progress Note

S

Patient attended Tinnitus Group Education Class 1 of 2

Veteran has previously been identified as having disturbing

tinnitus which might benefit from further management

Veterans with co-existing mental health disorders report greater

disturbance from tinnitus than those without co-existing mental

health disorders (Benton 2011) Veterans CPRS Problems tab

and other NOTES include the following mental health diagnos(es)

Veteran previously was diagnosed with hearing loss Hearing aid(s)

were provided by the veterans primary audiologist

Veteran previously was diagnosed with hearing loss Hearing aids

were recommended by the audiologist but veteran declined

Veteran previously was diagnosed with hearing loss Veterans

primary audiologist reported that hearing aids were not warranted

due to the nature andor configuration of the loss

Veteran previously has been found to have normal hearing thresholds

through 8000 Hz

OA

Prior to the start of the program all attendees were asked to

provide four measures

1 A global perception of overall tinnitus severity using a 5-point

response scale Not a Problem

A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem

2 The Tinnitus Functional Index or TFI (Meikle et al 2012) a

reliable and valid measure of overall tinnitus severity covering

eight domains with excellent sensitivity to treatment-related change

TFI scores range from 0-100 with higher numbers indicating greater

tinnitus severity

3 Estimates of the total percentage of waking hours over the

past week that veteran has been aware of the tinnitus

(Awareness ) and the percentage of that time veteran was truly

disturbed by the tinnitus (Disturbance ) These estimates then

are used to calculate the veterans Total Disturbance Value

that is the percentage of waking hours that veteran was

disturbed by the tinnitus

4 The PHQ9 (Kronke et al) is a concise self-administered

screening tool for depression It is designed to improve the


recognition rate of depression and anxiety thus facilitating

diagnosis and treatment

The veterans pre-Group Education responses were

-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness

Tinnitus Disturbance

Total Disturbance (A x D)

-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)

TFI scores range from 0-100 and may be interpreted as follows

0-25 Little or no need for intervention

26-50 Possible need for intervention

51+ Likely need for intervention

PHQ9 scores range from 0-27 and may be interpreted as follows

1-4 Minimal depression

5-9 Mild depression

10-14 Moderate depression

15-19 Moderately severe depression

20-27 Severe depression

Veteran responded YES NO to the PHQ9 question In the past 2 years have

you felt depressed or sad on most days even if you felt okay sometimes

Veteran responded to the PHQ9 question 10 If you checked off any

problems how difficult have these problems made it for you to do

your work take care of things at home or get along with other people

as

not difficult at all

somewhat difficult

very difficult

extremely difficult

Because a small percentage of veterans with disturbing tinnitus

report that their tinnitus has led to thoughts of suicide all

attendees were informed about VA suicide prevention services and

were given the Suicide Prevention Hotline phone number Attendees

also were informed that question 9 of the PHQ9 asks specifically

about suicidal ideation related to tinnitus Attendees were instructed

to speak with the audiologist immediately following the Tinnitus Class

for immediate referral to Mental Health Service (Walk-In) if they had

active plans for suicide had attempted to obtain the means for

committing suicide or had previously attempted suicide

Veteran denied any suicidal ideation per response to

Question 9 of the PHQ9

Veteran reported suicidal ideation related to tinnitus per

response to Question 9 of the PHQ9


Records indicate that veteran IS NOT currently being followed

by VA mental health clinic(s)

Veterans most recent MH progress note was dated

The patients primary care provider andor mental health care provider

if the patient currently is being seen by MH Clinic) waswere added

as cosigner(s) to this note to assure their awareness of veterans

status

Tinnitus Group Education Class 1 then consisted of a two-hour program

which included numerous educational components including the nature

and causes of tinnitus the use of sound to manage tinnitus disturbance

and annoyance through contrast reduction and the use of music and other

relaxation techniques to reduce stress associated with tinnitus

Veteran was provided a personal copy of the workbook Managing Your

Tinnitus for reference at home and reproducible copies of all

associated worksheets The workbook includes a DVD of the material

presented today for viewing at patients convenience for review as

well as a CD of different types of interesting relaxing and

background sounds Additionally veteran was provided a listing of

internet resources for free music nature sounds guided relaxation

guided imagery and other sounds to facilitate proactive self-

management of tinnitus

Diagnosis is 38831 - tinnitus

P

Patient was encouraged to implement the strategies discussed

today for reduction of tinnitus annoyance

Veteran to return for Tinnitus Group Education Class 2 in two weeks

for Sound Plan review and discussion of additional strategies for

managing disturbing tinnitus

The clinic will mail a follow-up TFIPHQ9 questionnaire to veteran

approximately 4 weeks after Tinnitus Group Education Class 2 to

assess management outcome allowing adequate time for veteran to

develop and evaluate Sound Plans and other strategies for reduction

of tinnitus annoyance A determination then will be made regarding

any possible need for an individualized tinnitus management

appointment


Using Sound During Pleasant Activities

1 What type of PLEASANT ACTIVITY are you enjoying Remember do something you WANT

or LIKE to do not something you HAVE to do

a Educational Learning how to operate a computer

b Artistic Paint a mural on the living room wall

c Social Call a buddy

d Athletic Take a walk around the neighborhood

e Relaxation Read a book

2 What TYPE OF SOUND is most appropriate for that PLEASANT ACTIVITY

a Background Sound Eliminates silence which makes your tinnitus less noticeable

i Music (usually without words)

1 Computer speakers

2 Mp3 player

ii Environmental Sound

1 Sound generator

2 Open the windows (on a nice day)

iii Speech ndash typically not recommended but some people do well with a TV

playing in the background

b Interesting Sound

i Music (usually with words)

1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator


3 Could ask a friend to work with you (Interesting Sound-conversation)


iii Speech

1 Cell phone conversation

a Bluetooth headset for cell phone conversation

b Cell phone by itself

2 Home phone conversation

3 Face-to-face conversation

4 Books on tape (mp3 player CD player)

5 Speeches sermons (recorded via mp3 player CD player TV Radio)

c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows

iii Ask a friend to work with you (Interesting Sound-conversation speech)








Tinnitus Group Education Class 2 Progress Note S

Patient attended the Tinnitus Group Education - Class 2 program

Veteran had previously attended Audiology Tinnitus Group Education Class 1

at which time veteran was provided a personal copy of the workbook

Managing Your Tinnitus for reference at home and reproducible copies of

all associated worksheets The workbook includes a DVD of the material

presented today for viewing at patients convenience for review as well as

a CD of different types of interesting relaxing and background sounds

Additionally veteran was provided a listing of internet resources for free

music nature sounds guided relaxation guided imagery and other sounds to

facilitate proactive self-management of tinnitus

OA

Class 2 consisted of a two-hour program which included numerous educational

components including a brief review of information provided in Class 1

Primary causes of tinnitus

Why tinnitus can be so disturbing

Using sound to manage tinnitus

Creating and implementing Sound Plans

New information was then introduced according to Progressive Tinnitus

Management protocol regarding changing reactions to and thoughts about

tinnitus as a complement to the use of Sound Plans

Specifically information was divided into three sections

Relaxation

Pleasant Activity Planning

Changing Thoughts About Tinnitus

Various exercises were completed within a supportive group environment

to demonstrate the information provided


P

The clinic will mail a follow-up questionnaire to veteran in

approximately 4 weeks to assess management outcome allowing adequate time

for veteran to implement and evaluate the discussed strategies for

reduction of tinnitus annoyance Based on a comparison of pre- and post-

Group Education TFI scores a determination then will be made regarding

any possible need for an individualized tinnitus management appointment

All attendees were informed that if an individualized tinnitus management

appointment is indicated they will be required to bring their completed

Sound Plans and other worksheets for review They also were informed that

failure to demonstrate a good-faith effort to implement the strategies

would preclude progression to more intensive tinnitus management strategies


Tinnitus Group Outcome Progress Note Addendum

S

Veterans Tinnitus Group Outcome questionnaire was received today

The questionnaire was composed of

1 The Self-Efficacy for Managing Reactions to Tinnitus or SMRT

(Henry et al ) a 17-item questionnaire evaluating a patients

confidence that he or she can manage tinnitus successfully using

sound and other strategies and skills taught as part of the

Atlanta VAs Progressive Tinnitus Management program

The SMRT contains six items that are near-verbatim duplicates of

the items that make up the Self-Efficacy for Managing Chronic Disease

6-Item Scale or SEMCD6 (Lorig et al 2001) Original psychometric

data revealed a mean score of 52 among 605 individuals with multiple

chronic diseases More recent normative data are available for a

German version of the scale (Freund et al 2011) and revealed a mean

score of 67 among 244 individuals with multiple chronic diseases

At the Atlanta VA we averaged the 849 SEMCD6 scores from the two



The mean of all 17 SMRT responses is the total SMRT score Lower

scores indicate lower self-confidence for managing tinnitus

Although norms are not yet available in this clinic total SMRT

scores above 56 are considered indicative of adequate confidence

for managing tinnitus and are consistent with no need for further

tinnitus management





OA

The veterans current total SMRT score and current and previous PHQ-9 scores

are shown below post-Group Education Outcome measures are compared to

veterans pre-Group Education measure below

-------------------------------------------------

Measure Current Previous

-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance

Total Disturbance (A X D)

-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult

Because a small percentage of veterans with disturbing tinnitus report that

their tinnitus has led to thoughts of suicide all Tinnitus Group Education

attendees have been informed about VA suicide prevention services and have

been given the Suicide Prevention Hotline phone number Question 9 of the

PHQ-9 asks specifically about suicidal ideation

Veteran denied any suicidal ideation per response to PHQ-9

Question 9

Veteran reported suicidal ideation per response to PHQ-9

Question 9


for mental health issues

The patients primary care provider and mental health care provider

(if the patient currently is being seen by MH Clinic) have already

been made aware of the veterans status

Veterans total SMRT score is consistent with NO need for further

Tinnitus management

Although veterans post-group responses are consistent with an

improvement in overall tinnitus disturbance results continue

to indicate significant tinnitus disturbance

Veteran continues to experience disturbing tinnitus and is unable to

manage his tinnitus successfully using only the knowledge tools and

skills provided at Audiology Tinnitus Group Education

Veterans outcome are consistent with no need for any further tinnitus

management Veteran has demonstrated the ability to manage the tinnitus

successfully using only the knowledge tools and skills provided at

Audiology Tinnitus Group Education

Veteran wrote the following regarding use of the information provided

in the classes (these are exact transcriptions)

1 Sound Plans

2 Relaxation

3 Planning Pleasant Activities

4 Changing Thoughts About Tinnitus

5 The Tinnitus Classes in General

6 Do you feel you need more help to manage your tinnitus

P

Veterans total SMRT score is consistent with no need for further

tinnitus management Veteran will contact the clinic for assistance on an

as needed basis


However veteran failed to attend Class 2 of tinnitus Group Education

Veteran will be scheduled for Class 2

Although the total SMRT score suggests that veteran may benefit

from further tinnitus services from VA veteran reported there was no

need for further tinnitus services from VA

Veteran was scheduled for individual tinnitus consultation at which

time we will review the various strategies veteran has implemented

per previous recommendations Determination of any need for

comprehensive tinnitus assessment and any individualized tinnitus

management will be made after review of these strategies


Group Education Outcomes SMRT and PHQ9

Dear Veteran

It has been about four weeks since Tinnitus Class 2 so Ive enclosed a questionnaire to find

out how you are doing since you learned various strategies and skills to manage your tinnitus

In the classes we talked about Sound Plans Relaxation Planning Pleasant Activities and

Changing Thoughts About Tinnitus I hope you have learned to use these strategies to control

your tinnitus rather than have it control you

Also I am very interested in any comments you may be able to provide about what you learned

from the classes Please return this sheet with the attached questionnaires Thank you

NAME ______________________________ SSN _____________________ DATE _______________

1 Please share one of your Sound Plans _______________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

2 Please share an example of Relaxation you tried _______________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

3 Please share an example of how you Planned Pleasant Activities __________________

_____________________________________________________________________________________

_____________________________________________________________________________________

4 How have you been Changing Thoughts About Your Tinnitus ____________________

_____________________________________________________________________________________

_____________________________________________________________________________________

5 What did you think of the Tinnitus Classes ________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

6 Do you feel you need further assistance working with your tinnitus YES NO

Please send back THIS SHEET along with THE QUESTIONNAIRES in the enclosed postage-paid

pre-addressed envelope I look forward to learning how youve been and what you think

Thank you

SBenton AuD


Tinnitus Questionnaire 1

Over the PAST TWO WEEKS

What percentage of waking hours were you AWARE of your tinnitus ______

What percentage of the time you were AWARE of your tinnitus did it actually BOTHER you ______





Over the last 2 weeks how often have you been bothered by

any of the following problems concerns

Not

at all

Several

days

More than

half the

days

Nearly

every day

Little interest or pleasure in doing things

Feeling down depressed or hopeless

Trouble falling or staying asleep or sleeping

too much

Feeling tired or having little energy

Poor appetite or overeating

Feeling bad about yourself ndash or that you are

failure or have let yourself or your family

down

Trouble concentrating on things such as

reading the newspaper or watching television

Moving or speaking so slowly that other

people could have noticed Or the opposite ndash

being so fidgety or restless that your have

been moving around a lot more than usual

Thoughts that you would be better off dead

or of hurting yourself in some way

In the past 2 years have you felt depressed or

sad on most days even if you felt okay

sometimes

Yes No

If you checked off any of the above problems

how difficult have these problems made it for

you to do your work take care of things at

home or get along with other people

Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult


4-dB Gain Reduction for NALNL1 Binaural Loudness Effect

Best Match to NALNL1


-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies



Triage

1 On the standard case history form patients are asked if they have tinnitus and to describe

the sound they perceive As noted those who experience tinnitus are asked to grade the

severity of their tinnitus using the THI-based grade levels described by McCombe et al

(2001)

2 Patients also are asked to describe how often they hear the tinnitus Patients may have

difficulty with this task

a Audiologists are encouraged to guide patients to provide an awareness

percentage (percentage of waking hours the patient hears the tinnitus)

b Otherwise audiologists may ask ldquo how often do you hear your tinnitus Once a

day once a weekhelliprdquo and ldquohow long does it last when you hear it A few

seconds a few minuteshelliprdquo

3 Patients who grade the tinnitus a 1 2 or 3 typically require no further tinnitus assessment

4 Patients who grade the tinnitus a 4 or 5 require further tinnitus screening

a The Tinnitus Severity Index or TSI (Meikle 1995) is completed This questionnaire

is best completed in an INTERVIEW FORMAT rather than by PAPERPENCIL

Patients often confuse hearing problems with tinnitus problems Interview

format allows the audiologist to maintain a focus on issues related to tinnitus

not hearing loss

b The questionnaire includes a 0-10 visual analog scale as well where 0 means

my tinnitus is not a problem at all and 10 means my tinnitus is the biggest

problem you can imagine

c Benton (2013) reported that a linear regression completed to evaluate the

predictive relationships between the independent variables 0-10 Problem and 1-

5 Tinnitus Grade and the dependent variable TSI Score resulted in the finding

that Not all of the independent variables appear necessary The following

appear to account for the ability to predict TSI (P lt 005) 0-10 VArdquoAs a result

the clinic now uses ONLY the 0-10 VAS as its single Triage measure





a Immittance

b Tympanometry






































ANDOR








various accessories




person









are met
















audible



















effective






































iii









EDUCATION













Group Education










Group Education






the patient






al 1991)







tinnitus






ideation





































tinnitus)







the next session



workbook








tinnitus)


situations











the PHQ9












patient

















previous week









both classes and


of lt 56
















above




results


















tinnitus management













c





management strategy






























































0 -------- 1 -------- 2 -------- 3 -------- 4 -------- 5 -------- 6 -------- 7-------- 8 -------- 9 -------- 10

Reference

























1 2 3 4 5



your leisure time

1 2 3 4 5





1

Can easily

ignore it

2

Some

effort

3

Considerable

effort

4

Can never

ignore it



present

1

No

discomfort

2

Mild

discomfort

3

Moderate

discomfort

4

A great deal

of

discomfort


No

2

Sometimes

3

Often

4

Always














1-888-430-4327




TWO ITEMS




TWO ITEMS


This kit is stocked

by Prosthetics































the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies





a Immittance

b Tympanometry






































ANDOR








various accessories




person









are met
















audible



















effective






































iii









EDUCATION













Group Education










Group Education






the patient






al 1991)







tinnitus






ideation





































tinnitus)







the next session



workbook








tinnitus)


situations











the PHQ9












patient

















previous week









both classes and


of lt 56
















above




results


















tinnitus management













c





management strategy






























































0 -------- 1 -------- 2 -------- 3 -------- 4 -------- 5 -------- 6 -------- 7-------- 8 -------- 9 -------- 10

Reference

























1 2 3 4 5



your leisure time

1 2 3 4 5





1

Can easily

ignore it

2

Some

effort

3

Considerable

effort

4

Can never

ignore it



present

1

No

discomfort

2

Mild

discomfort

3

Moderate

discomfort

4

A great deal

of

discomfort


No

2

Sometimes

3

Often

4

Always














1-888-430-4327




TWO ITEMS




TWO ITEMS


This kit is stocked

by Prosthetics































the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies



















ANDOR








various accessories




person









are met
















audible



















effective






































iii









EDUCATION













Group Education










Group Education






the patient






al 1991)







tinnitus






ideation





































tinnitus)







the next session



workbook








tinnitus)


situations











the PHQ9












patient

















previous week









both classes and


of lt 56
















above




results


















tinnitus management













c





management strategy






























































0 -------- 1 -------- 2 -------- 3 -------- 4 -------- 5 -------- 6 -------- 7-------- 8 -------- 9 -------- 10

Reference

























1 2 3 4 5



your leisure time

1 2 3 4 5





1

Can easily

ignore it

2

Some

effort

3

Considerable

effort

4

Can never

ignore it



present

1

No

discomfort

2

Mild

discomfort

3

Moderate

discomfort

4

A great deal

of

discomfort


No

2

Sometimes

3

Often

4

Always














1-888-430-4327




TWO ITEMS




TWO ITEMS


This kit is stocked

by Prosthetics































the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies




person









are met
















audible



















effective






































iii









EDUCATION













Group Education










Group Education






the patient






al 1991)







tinnitus






ideation





































tinnitus)







the next session



workbook








tinnitus)


situations











the PHQ9












patient

















previous week









both classes and


of lt 56
















above




results


















tinnitus management













c





management strategy






























































0 -------- 1 -------- 2 -------- 3 -------- 4 -------- 5 -------- 6 -------- 7-------- 8 -------- 9 -------- 10

Reference

























1 2 3 4 5



your leisure time

1 2 3 4 5





1

Can easily

ignore it

2

Some

effort

3

Considerable

effort

4

Can never

ignore it



present

1

No

discomfort

2

Mild

discomfort

3

Moderate

discomfort

4

A great deal

of

discomfort


No

2

Sometimes

3

Often

4

Always














1-888-430-4327




TWO ITEMS




TWO ITEMS


This kit is stocked

by Prosthetics































the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies

















effective






































iii









EDUCATION













Group Education










Group Education






the patient






al 1991)







tinnitus






ideation





































tinnitus)







the next session



workbook








tinnitus)


situations











the PHQ9












patient

















previous week









both classes and


of lt 56
















above




results


















tinnitus management













c





management strategy






























































0 -------- 1 -------- 2 -------- 3 -------- 4 -------- 5 -------- 6 -------- 7-------- 8 -------- 9 -------- 10

Reference

























1 2 3 4 5



your leisure time

1 2 3 4 5





1

Can easily

ignore it

2

Some

effort

3

Considerable

effort

4

Can never

ignore it



present

1

No

discomfort

2

Mild

discomfort

3

Moderate

discomfort

4

A great deal

of

discomfort


No

2

Sometimes

3

Often

4

Always














1-888-430-4327




TWO ITEMS




TWO ITEMS


This kit is stocked

by Prosthetics































the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies























iii









EDUCATION













Group Education










Group Education






the patient






al 1991)







tinnitus






ideation





































tinnitus)







the next session



workbook








tinnitus)


situations











the PHQ9












patient

















previous week









both classes and


of lt 56
















above




results


















tinnitus management













c





management strategy






























































0 -------- 1 -------- 2 -------- 3 -------- 4 -------- 5 -------- 6 -------- 7-------- 8 -------- 9 -------- 10

Reference

























1 2 3 4 5



your leisure time

1 2 3 4 5





1

Can easily

ignore it

2

Some

effort

3

Considerable

effort

4

Can never

ignore it



present

1

No

discomfort

2

Mild

discomfort

3

Moderate

discomfort

4

A great deal

of

discomfort


No

2

Sometimes

3

Often

4

Always














1-888-430-4327




TWO ITEMS




TWO ITEMS


This kit is stocked

by Prosthetics































the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies













Group Education










Group Education






the patient






al 1991)







tinnitus






ideation





































tinnitus)







the next session



workbook








tinnitus)


situations











the PHQ9












patient

















previous week









both classes and


of lt 56
















above




results


















tinnitus management













c





management strategy






























































0 -------- 1 -------- 2 -------- 3 -------- 4 -------- 5 -------- 6 -------- 7-------- 8 -------- 9 -------- 10

Reference

























1 2 3 4 5



your leisure time

1 2 3 4 5





1

Can easily

ignore it

2

Some

effort

3

Considerable

effort

4

Can never

ignore it



present

1

No

discomfort

2

Mild

discomfort

3

Moderate

discomfort

4

A great deal

of

discomfort


No

2

Sometimes

3

Often

4

Always














1-888-430-4327




TWO ITEMS




TWO ITEMS


This kit is stocked

by Prosthetics































the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies



Group Education






the patient






al 1991)







tinnitus






ideation





































tinnitus)







the next session



workbook








tinnitus)


situations











the PHQ9












patient

















previous week









both classes and


of lt 56
















above




results


















tinnitus management













c





management strategy






























































0 -------- 1 -------- 2 -------- 3 -------- 4 -------- 5 -------- 6 -------- 7-------- 8 -------- 9 -------- 10

Reference

























1 2 3 4 5



your leisure time

1 2 3 4 5





1

Can easily

ignore it

2

Some

effort

3

Considerable

effort

4

Can never

ignore it



present

1

No

discomfort

2

Mild

discomfort

3

Moderate

discomfort

4

A great deal

of

discomfort


No

2

Sometimes

3

Often

4

Always














1-888-430-4327




TWO ITEMS




TWO ITEMS


This kit is stocked

by Prosthetics































the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies





































tinnitus)







the next session



workbook








tinnitus)


situations











the PHQ9












patient

















previous week









both classes and


of lt 56
















above




results


















tinnitus management













c





management strategy






























































0 -------- 1 -------- 2 -------- 3 -------- 4 -------- 5 -------- 6 -------- 7-------- 8 -------- 9 -------- 10

Reference

























1 2 3 4 5



your leisure time

1 2 3 4 5





1

Can easily

ignore it

2

Some

effort

3

Considerable

effort

4

Can never

ignore it



present

1

No

discomfort

2

Mild

discomfort

3

Moderate

discomfort

4

A great deal

of

discomfort


No

2

Sometimes

3

Often

4

Always














1-888-430-4327




TWO ITEMS




TWO ITEMS


This kit is stocked

by Prosthetics































the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies




tinnitus)







the next session



workbook








tinnitus)


situations











the PHQ9












patient

















previous week









both classes and


of lt 56
















above




results


















tinnitus management













c





management strategy






























































0 -------- 1 -------- 2 -------- 3 -------- 4 -------- 5 -------- 6 -------- 7-------- 8 -------- 9 -------- 10

Reference

























1 2 3 4 5



your leisure time

1 2 3 4 5





1

Can easily

ignore it

2

Some

effort

3

Considerable

effort

4

Can never

ignore it



present

1

No

discomfort

2

Mild

discomfort

3

Moderate

discomfort

4

A great deal

of

discomfort


No

2

Sometimes

3

Often

4

Always














1-888-430-4327




TWO ITEMS




TWO ITEMS


This kit is stocked

by Prosthetics































the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies







the PHQ9












patient

















previous week









both classes and


of lt 56
















above




results


















tinnitus management













c





management strategy






























































0 -------- 1 -------- 2 -------- 3 -------- 4 -------- 5 -------- 6 -------- 7-------- 8 -------- 9 -------- 10

Reference

























1 2 3 4 5



your leisure time

1 2 3 4 5





1

Can easily

ignore it

2

Some

effort

3

Considerable

effort

4

Can never

ignore it



present

1

No

discomfort

2

Mild

discomfort

3

Moderate

discomfort

4

A great deal

of

discomfort


No

2

Sometimes

3

Often

4

Always














1-888-430-4327




TWO ITEMS




TWO ITEMS


This kit is stocked

by Prosthetics































the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies







previous week









both classes and


of lt 56
















above




results


















tinnitus management













c





management strategy






























































0 -------- 1 -------- 2 -------- 3 -------- 4 -------- 5 -------- 6 -------- 7-------- 8 -------- 9 -------- 10

Reference

























1 2 3 4 5



your leisure time

1 2 3 4 5





1

Can easily

ignore it

2

Some

effort

3

Considerable

effort

4

Can never

ignore it



present

1

No

discomfort

2

Mild

discomfort

3

Moderate

discomfort

4

A great deal

of

discomfort


No

2

Sometimes

3

Often

4

Always














1-888-430-4327




TWO ITEMS




TWO ITEMS


This kit is stocked

by Prosthetics































the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies










above




results


















tinnitus management













c





management strategy






























































0 -------- 1 -------- 2 -------- 3 -------- 4 -------- 5 -------- 6 -------- 7-------- 8 -------- 9 -------- 10

Reference

























1 2 3 4 5



your leisure time

1 2 3 4 5





1

Can easily

ignore it

2

Some

effort

3

Considerable

effort

4

Can never

ignore it



present

1

No

discomfort

2

Mild

discomfort

3

Moderate

discomfort

4

A great deal

of

discomfort


No

2

Sometimes

3

Often

4

Always














1-888-430-4327




TWO ITEMS




TWO ITEMS


This kit is stocked

by Prosthetics































the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies





tinnitus management













c





management strategy






























































0 -------- 1 -------- 2 -------- 3 -------- 4 -------- 5 -------- 6 -------- 7-------- 8 -------- 9 -------- 10

Reference

























1 2 3 4 5



your leisure time

1 2 3 4 5





1

Can easily

ignore it

2

Some

effort

3

Considerable

effort

4

Can never

ignore it



present

1

No

discomfort

2

Mild

discomfort

3

Moderate

discomfort

4

A great deal

of

discomfort


No

2

Sometimes

3

Often

4

Always














1-888-430-4327




TWO ITEMS




TWO ITEMS


This kit is stocked

by Prosthetics































the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies





















































0 -------- 1 -------- 2 -------- 3 -------- 4 -------- 5 -------- 6 -------- 7-------- 8 -------- 9 -------- 10

Reference

























1 2 3 4 5



your leisure time

1 2 3 4 5





1

Can easily

ignore it

2

Some

effort

3

Considerable

effort

4

Can never

ignore it



present

1

No

discomfort

2

Mild

discomfort

3

Moderate

discomfort

4

A great deal

of

discomfort


No

2

Sometimes

3

Often

4

Always














1-888-430-4327




TWO ITEMS




TWO ITEMS


This kit is stocked

by Prosthetics































the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies































0 -------- 1 -------- 2 -------- 3 -------- 4 -------- 5 -------- 6 -------- 7-------- 8 -------- 9 -------- 10

Reference

























1 2 3 4 5



your leisure time

1 2 3 4 5





1

Can easily

ignore it

2

Some

effort

3

Considerable

effort

4

Can never

ignore it



present

1

No

discomfort

2

Mild

discomfort

3

Moderate

discomfort

4

A great deal

of

discomfort


No

2

Sometimes

3

Often

4

Always














1-888-430-4327




TWO ITEMS




TWO ITEMS


This kit is stocked

by Prosthetics































the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies

























0 -------- 1 -------- 2 -------- 3 -------- 4 -------- 5 -------- 6 -------- 7-------- 8 -------- 9 -------- 10

Reference

























1 2 3 4 5



your leisure time

1 2 3 4 5





1

Can easily

ignore it

2

Some

effort

3

Considerable

effort

4

Can never

ignore it



present

1

No

discomfort

2

Mild

discomfort

3

Moderate

discomfort

4

A great deal

of

discomfort


No

2

Sometimes

3

Often

4

Always














1-888-430-4327




TWO ITEMS




TWO ITEMS


This kit is stocked

by Prosthetics































the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies






















1 2 3 4 5



your leisure time

1 2 3 4 5





1

Can easily

ignore it

2

Some

effort

3

Considerable

effort

4

Can never

ignore it



present

1

No

discomfort

2

Mild

discomfort

3

Moderate

discomfort

4

A great deal

of

discomfort


No

2

Sometimes

3

Often

4

Always














1-888-430-4327




TWO ITEMS




TWO ITEMS


This kit is stocked

by Prosthetics































the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies








1-888-430-4327




TWO ITEMS




TWO ITEMS


This kit is stocked

by Prosthetics































the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies




1-888-430-4327




TWO ITEMS




TWO ITEMS


This kit is stocked

by Prosthetics































the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies































the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies



























the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies

























the device





other location






soothing sounds



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies



What is Tinnitus


















care professional






available









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies









































































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies










































professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies










professional















































online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies



























online


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies


What does loud mean




20 dB

30 dB

40 dB

50 dB

60 dB

70 dB

80 dB

Ticking watch

Quiet whisper

Refrigerator hum

Rainfall

Sewing machine

Washing machine


85 dB

95 dB

100 dB

105 dB

110 dB

120 dB

130 dB

Average traffic

MRI



Screaming child



Noisy workplaces















How damage occurs










treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies





treatment stage




























break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies



break


About earplugs










generates sound













Will it get louder

Generally not






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies






It cant be cured



life











































your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies



















your tinnitus











































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies































well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies



















well






















it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies










it
















































and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies

























and well tolerated






relaxing

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies

































































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies































































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies

































a good idea


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies


Other Factors
























S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies











S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies









S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies







S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies





S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies




S



OA









------------------------------------------------------------------


------------------------------------------------------------------

1 Use 3-5

2 Benefit 3-4


4 Satisfaction 2-5





------------------------------------------------------------------



this time








responses indicated













P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies









P




appointment














Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies








Class 1
















Class 2
























Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies













Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies









Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies








Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies





Not

at all


Some of the time

A good deal of

the time

Almost all of

the time




























Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies


Suicide Risk Flag



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies



Not a

problem

A small

problem

A moderate

problem

A big

problem

A very big

problem






on TV or movies





group conversations


from sleeping




from relaxing












S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies






S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies



S
















through 8000 Hz

OA





A Small Problem

A Moderate Problem

A Big Problem

A Very Big Problem





tinnitus severity














-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies





-----------------------------------------

Global Severity

-----------------------------------------

TFI - Score

-----------------------------------------

Tinnitus Awareness



-----------------------------------------

PHQ-9 Score

-----------------------------------------

(na = not answered)







5-9 Mild depression









as


somewhat difficult

very difficult

extremely difficult






















status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies








status
















P












appointment













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies













1 Computer speakers

2 Mp3 player


1 Sound generator




b Interesting Sound


1 Computer speakers

2 Mp3 player

3 Portable boom box


1 Sound generator




iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies


iii Speech








c Relaxing Sound


1 Computer speakers

2 Mp3 player


1 Sound generator

2 Open the windows




















OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies













OA











Relaxation






P














S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies



S























tinnitus management





OA




-------------------------------------------------


-------------------------------------------------

SMRT Score XXX

-------------------------------------------------

Awareness

Disturbance


-------------------------------------------------

PHQ-9 Score

-------------------------------------------------

(na = not answered)







as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies





as


somewhat difficult

very difficult

extremely difficult







Question 9


Question 9







Tinnitus management













1 Sound Plans

2 Relaxation





P



as needed basis














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies














Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies



Dear Veteran








NAME ______________________________ SSN _____________________ DATE _______________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________


_____________________________________________________________________________________

_____________________________________________________________________________________




Thank you

SBenton AuD












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies












Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies







Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies






Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies





Not

at all

Several

days

More than

half the

days

Nearly

every day




too much





down











sometimes

Yes No





Not

difficult

at all

Somewhat

difficult

Very

difficult

Extremely

difficult





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies





-4dB at All

Matched

Frequencies

-4dB at All

Matched

Frequencies

Documents

Atlanta VA Medical Center Tinnitus Program · Patients often confuse hearing problems with tinnitus problems. Interview format allows the audiologist to maintain a focus on issues