Hyperacusis Impact Questionnaire (Adult version)

Please answer each item to the best of your ability as close to your experience as possible.

Over the last 2 weeks, how often would you say the following has occurred because of certain environmental sounds which seemed too loud to you but people around you could tolerate them well?

(Use "✓" to indicate your answer)

1. Feeling anxious when hearing loud noises	0 - 1 day	2 - 6 days	7 - 10 days	11 - 14 days
2. Avoiding certain places because it is too noisy	0 - 1 day	2 - 6 days	7 - 10 days	11 - 14 days
3. Lack of concentration in noisy places	0 - 1 day	2 - 6 days	7 - 10 days	11 - 14 days
4. Unable to relax in noisy places	0 - 1 day	2 - 6 days	7 - 10 days	11 - 14 days
5. Difficulty in carrying out certain day-to-day activities/tasks in noisy places	0 - 1 day	2 - 6 days	7 - 10 days	11 - 14 days
6. Lack of enjoyment from leisure activities in noisy places	0 - 1 day	2 - 6 days	7 - 10 days	11 - 14 days
7. Experiencing low mood because of your intolerance to sound	0 - 1 day	2 - 6 days	7 - 10 days	11 - 14 days
8. Getting tired quickly in noisy places	0 - 1 day	2 - 6 days	7 - 10 days	11 - 14 days