Gipping Hearing Test Questionnaire

Please complete the following questions prior to your hearing test appointment. The questionnaire will be held with your confidential health records. This assessment is part of a health surveillance programme. As part of that programme, the outcome of this assessment will be provided to management to ensure continued protection of your hearing.

To record an accurate hearing test it is ESSENTIAL that you are not exposed to noise levels above 80dbs for at least 8 hours prior to the test. This includes exposure to noise associated with social activities (such as attending nightclubs; use of firearms; participation in motor sports; DIY jobs using machine power tools).

If you are driving to work on a motor bike or open top vehicle please wear ear defenders. Avoid listening to the car radio/music/audio systems at loud volumes or driving at speed with the windows down.

Once at work and engaging in tasks please put on ear defenders and wear them CONTINUOUSLY until arrival at your appointment.

Please bring your ear defenders with you whether or not you have needed to wear them on the day of your appointment.

If you suspect you may have a buildup of wax in your ears please ensure you have contacted your GP practice for treatment prior to your hearing test assessment. If there is a considerable build up of ear wax the hearing test cannot be completed.

Please arrive 5 minutes before the appointment time.

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