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Hearing Loss Questionnaire
Hearing Impaired
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Age Group
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30 to 49 years old
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Hearing Report Attached?
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Hearing Loss Level?
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Hearing in Both Ear Balanced or is One Side Worse?
Do You Wear Hearing Aids?
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Please Provide Hearing Aids Brand and URL link of the Product
You Watch TV for ____ hours a day?
Issue with current hearing Enhanced products?
Ideal hearing Enhanced products, over-the-ear, neckband or? What functions are important?
What Avantree products are you using now?
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