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Step
1
of
11
9%
For Whom do you need hearing aid?
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For Myself
For My Parents
For My Child
For My Grand Parents
Does the person in question already have a hearing aid?
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Yes
No
Did the doctor recommend hearing aids?
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Yes
No
Has a hearing test been conducted by a doctor?
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Yes
No
How soon should the hearing loss be improved?
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As soon as possible
Within the next few weeks
Within the next few months
I don't know
How important is a discreet design?
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Unimportant
Important
Very important
Which hearing situations are difficult?
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One-on-one conversations
Group conversations
Restaurant / bar
Conference
Church / concerts
How much does the hearing loss restrict the daily life?
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Not at all
Barely
Severely
What has prevented you from getting hearing aids sooner?
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Not sure if I need them
I can't afford them
I need more information
I've been too busy
To evaluate your best possible affordability plan, please tell us in which income group you belong (income per month).
*
Less than INR 20,000
INR 20,000 – INR 50,000
INR 50,001 – INR 100,000
More than INR 100,001
Name
*
Phone
*
Comment
How old is the person in question? (Eg. 57)
*
Please enter a number from
1
to
99
.
Please enter your Area PIN code:
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Send the Report (name@gmail.com)
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