Tinnitus Impact Questionnaire

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 hearing a sound in your ears or head with no external source (e.g., buzzing, high-pitched whistle, hissing…)?

(Use "✓" to indicate your answer)

1. Lack of concentration
2. Feeling anxious
3. Sleep difficulties (delay in falling sleep and/or difficulty getting back to sleep if woken up during the night)
4. Lack of enjoyment from leisure activities
5. Inability to perform certain day-to-day activities/tasks
6. Feeling irritable
7. Low mood
For Hearing Healthcare Professionals