Hearing Analysis

Find out what you're missing. Northwest Ohio Hearing Clinic offers a Free Hearing Analysis. Fill out this form to set up an appointment for your free hearing analysis at our Toledo or Perrysburg locations:

  1. Do you find that people seem to mumble?

  2. Are the voices of young children hard to understand?

  3. Do you sometimes misunderstand what is being said when you are in cars or restaurants?

  4. Do you have trouble understanding a conversation when there is background noise or when people are all talking at the same time?

  5. Do you find yourself often asking people to repeat themselves?

  6. Do you experience "ringing in the ears" (Tinnitus)?

  7. Have your family or friends ever suggested that you have a hearing problem?

  8. Do you find it difficult to locate where a sound is coming from?

  9. Do you need to sit near the front row close to the speaker when attending a public speaking event?

  10. Do you find it easier to hear when you are looking directly at the person who is speaking to you?

  11. Do family and friends complain that the volume is too high when you are watching television or listening to the stereo?

If you answered "yes" to one or more of the questions, it does not necessarily indicate that you have a hearing problem, however we would suggest that you contact us to have your hearing checked. Please fill in your details below and click on submit. We will then contact you if you have indicated that you would like us to do so.


Please contact me to discuss the results of this hearing test.

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Patient Information Form

Pediatric Case History Form

Adult Case History Form

Vestibular Assessment Instructions

Balance Disorder Questionnaire


Hear what our patients
are saying...

"For many years I have been helped with my hearing loss in ways that even my family doesn't get. I have come in crying and just their understanding and patience with me makes the world of difference. I sincerely thank EVERYONE for being there for me."

SD, Toledo

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