Tinnitus Visual Analog Scale (VAS)
Pre-Assessment

Question Title

1. Please Type in Your Name:

Question Title

2. How much annoyance do you experience from your tinnitus?

0 (No Annoyance)

1

2

3

4

5

6

7

8

9

10 (Extreme Annoyance)

0 (No Annoyance)

1

2

3

4

5

6

7

8

9

10 (Extreme Annoyance)

Question Title

3. How loud would you rate your tinnitus?

0 (Undetectable)

1

2

3

4

5

6

7

8

9

10 (Extremely Loud)

0 (Undetectable)

1

2

3

4

5

6

7

8

9

10 (Extremely Loud)