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Lyric Lifestyle Checklist

1. In what situations do you feel you want/need better hearing?
(Check as many as apply.)
  Watching TV
Crowded or noisy places
Place of worship
Talking in groups
Conversations with soft voices
Business meetings		 Outdoors
On the phone
Lectures
Exercise activities
Concerts

2. Please determine the level of importance you hold for each item below
(Choose the number corresponding to the level of importance based on the scale below.)
   
Not Important
Very Important
      1   2   3   4   5
 
  Invisibility
(i.e., cannot see device at all)
 
  Easy to use
 
  Minimal amount of
user maintenance required
(i.e. changing batteries, making repairs)
 
  Ability to wear in most situations
(i.e. no need to remove device for activities such as exercising, talking on the phone)
   
3. How often do you perform the following activities?
  Swimming or water activities (e.g. scuba diving) where head is submerged:
         Often (> 3x / week)   Sometimes (1-2x / week)    Infrequently
  Do you skydive on a regular basis?
         Yes    No
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©2009 InSound Medical, Inc. All rights reserved.
Lyric is not appropriate for all patients. See your ENT physician, audiologist or hearing aid dispenser to determine if Lyric is right for you. Individual patients results may vary. *Professional fees may apply. Annual subscription begins the first day of trial.
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