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TINNITUS FUNCTIONAL INDEX

Please read each question below carefully. To answer a question, select ONE of the numbers that is listed for that question.

I Over the PAST WEEK...
1 What percentage of your time awake were you consciously AWARE OF your tinnitus?
Never aware (%)Allways aware
2 How STRONG or LOUD was your tinnitus?
Not at all strong or loudExtremely strong or loud
3 What percentage of your time awake were you ANNOYED by your tinnitus?
None of the time (%)All of the time
SC Over the PAST WEEK...
4 Did you feel IN CONTROL in regard to your tinnitus?
Very much in controlNever in control
5 How easy was it for you to COPE with your tinnitus?
Very easy to copeImpossible to cope
6 How easy was it for you to IGNORE your tinnitus?
Very easy to ignoreImpossible to ignore
C Over the PAST WEEK, how much did your tinnitus interfere with...
7 Your ability to CONCENTRATE?
Did not interfereCompletely interfered
8 Your ability to THINK CLEARLY?
Did not interfereCompletely interfered
9 Your ability to FOCUS ATTENTION on other things besides your tinnitus?
Did not interfereCompletely interfered
SL Over the PAST WEEK...
10 How often did your tinnitus make it difficult to FALL ASLEEP or STAY ASLEEP?
Never had difficultyAlways had difficulty
11 How often did your tinnitus cause you difficulty in getting AS MUCH SLEEP as you needed?
Never had difficultyAlways had difficulty
12 How much of the time did your tinnitus keep you from SLEEPING as DEEPLY or as PEACEFULLY as you would have liked?
None of the time (%)All of the time
A A Over the PAST WEEK, how much has your tinnitus interfered with...
13 Your ability to HEAR CLEARLY?
Did not interfereCompletely interfered
14 Your ability to UNDERSTAND PEOPLE who are talking?
Did not interfereCompletely interfered
15 Your ability to FOLLOW CONVERSATIONS in a group or at meetings?
Did not interfereCompletely interfered
R Over the PAST WEEK, how much has your tinnitus interfered with...
16 Your QUIET RESTING ACTIVITIES?
Did not interfereCompletely interfered
17 Your ability to RELAX?
Did not interfereCompletely interfered
18 Your ability to enjoy 'PEACE AND QUIET'?
Did not interfereCompletely interfered
Q Over the PAST WEEK, how much has your tinnitus interfered with...
19 Your enjoyment of SOCIAL ACTIVITIES?
Did not interfereCompletely interfered
20 Your ENJOYMENT OF LIFE?
Did not interfereCompletely interfered
21 Your RELATIONSHIPS with family, friends and other people?
Did not interfereCompletely interfered
22 How often did your tinnitus cause you to have difficulty performing your WORK OR OTHER TASKS, such as home maintenance, school work, or caring for children or others?
Never had difficulty Always had difficulty
E Over the PAST WEEK...
23 How ANXIOUS or WORRIED has your tinnitus made you feel?
Not at all anxious or worriedExtremely anxious or worried
24 How BOTHERED or UPSET have you been because of your tinnitus?
Not at all bothered or upsetExtremely bothered or upset
25 How DEPRESSED were you because of your tinnitus?
Not at all depressedExtremely depressed