Transcription of THE FUNCTIONAL LISTENING EVALUATION
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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: None Hearing Aids FM Cochlear Implant Sound Field Other_____ Classroom Ambient Noise Level (unoccupied).
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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