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. Delay in falling asleep
4. Difficulty going back to sleep if woken up during the night
5. Lack of enjoyment from leisure activities
6. Inability to perform certain day-to-day activities/tasks
7. Feeling irritable
8. Low mood
9. Feeling worried
For Hearing Healthcare Professionals