2-minute hearing questionnaire

Answer a few quick questions and find out which BLUEMOTH solution is right for you

What brings you here today? *

I'm looking for hearing aids

I'm looking for tinnitus treatment

I'm helping someone else

My hearing aids need service

I'm learning about hearing health

Which of the following is most important to your relief? *

Improved sleep

Reduced tension, frustration, or irritability

Improved concentration

Improved work or family life

What's your main motivation to improve your hearing? *

Connect with my community through conversation

Improve my mental health and wellbeing

Protect my cognitive health

Enjoy more of the media and hobbies I love

Do you currently own hearing aids? *

Yes

Has your hearing been tested in the last 6 months? *

Yes, by a hearing care professional
Yes, I took an online screening
No, its been longer than 6 months
No, I've never had my hearing tested
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How often do you wear your hearing aids? *

More than half the day
Less than half the day
Only in specific instances
Rarely
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How long have you had your hearing aids? *

less than 1 year
1-3 years
3-5 years
more than 5 years
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Age

18-35
36-45
46-60
60-75
75+
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Tell us about your hearing and lifestyle preferences below, so we can fine-tune your recommendation.

I enjoy an active lifestyle

Yes

Somewhat

I enjoy social events with large groups

Yes

Somewhat

I enjoy streaming media

Yes

Somewhat

I am frequently on the go

Yes

Somewhat

I find it challenging to hear in background noise

Yes

Somewhat

I prefer the most innovative tech with all the latest features

Yes

Somewhat

Is there anything else you would like to share about your hearing health?

Where should we send your hearing quiz results?

We'll be in touch to discuss your hearing needs.

First Name *

Last Name *

Email *

Phone *

Postal code

By providing my information, I agree to be contacted via the provided channels. Message and data rates may apply as imposed by my carrier. I know I can opt out of communication at any time by managing my preferences via email or replying STOP via SMS.