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1.
Age at onset of Hearing Loss
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2.
How many Hearing Aids did BDHHS help you get?
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3.
Is this your first Hearing Aid?
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4.
On average, how many hours did you use your Hearing Aid(s)?
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5.
Has your Hearing Aid(s) helped you in situations when you most wanted to hear?
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6.
Comments
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7.
Prior to getting the Hearing Aid(s), how much did your hearing difficulties affect the things you do?
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8.
Comments
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9.
How has your Hearing Aid(s) changed your enjoyment of life?
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10.
Comments
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11.
Do you agree that services at BDHHS improved the quality of your life?
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12.
Has your hearing improved and your hearing needs have been met since you got your hearing aids?
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13.
Was Lori Fisher helpful and knowledgeable?
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14.
Comments
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15.
Were you given an appointment in a timely manner?
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16.
Do you have any suggestions to improve our services?
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17.
How long did it take you from start of application to receive your Hearing Aid(s)?
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18.
What's your gender?
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19.
What's your age?
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20.
What's your ethnicity
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21.
What's your Zip Code?
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