THE FUNCTIONAL LISTENING EVALUATION
Revised 2004 by Johnson. Based on FUNCTIONAL LISTENING EVALUATION by Johnson & P. Von Almen, 1993. 4 THE FUNCTIONAL LISTENING EVALUATION Name:___________________________________ __________________ Date:_______________ Examiner:_______________________________ _______ Age/DOB:____________ AUDIOMETRIC RESULTS Hearing Sensitivity: Pure Tone Ave: Right Ear____dB Left Ear____dB Word Recognition: Right Ear____% @ ___dBHL Left Ear____% @ ___dBHL Sound Field: Aided Unaided Quiet _____% @ _____dBHL Noise _____% @ _____dBHL @ _____S/N FUNCTIONAL LISTENING EVALUATION CONDITIONS Amplification.
Revised 2004 by Johnson. Based on Functional Listening Evaluation by C.D. Johnson & P. Von Almen, 1993. 4 THE FUNCTIONAL LISTENING EVALUATION
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