We are gathering information about VA audiology appointment wait times and VA audiology clinic accessibility issues. For the purpose of this survey, audiology services are defined as hearing tests, hearing aid evaluations, and fitting, dispensing, follow-up, and repair services.

These anonymous responses will be shared with Congressional offices and other stakeholders.

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* 1. What is the name of the VA clinic that is closest to you that provides audiology services?

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* 2. Approximately how long is the drive from your WORKPLACE to the closest VA clinic that provides audiology services?

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* 3. Approximately how long is the drive from your HOME to the closest VA clinic that provides audiology services?

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* 4. How long would you estimate is the wait time for an audiology appointment with the nearest VA clinic?

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* 5. In what state or U.S. territory do you reside?

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* 6. In which COUNTY do you reside?

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* 7. In which TOWN do you reside?

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* 8. Are you a Veteran, hearing healthcare provider, or friend/family of a Veteran with hearing loss? (please check all that apply)

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