We are trying to establish what you like to do and how your hearing aids can be programmed to allow you to hear clearly and also enjoy your activity. Look at the checklist and rate each activity according to the scale below. Feel free to add other activities and comments to the list. Take this list or make your own list when you visit your audiologist/HIP.

Click here to download a printable PDF of the Lifestyle checklist!


1. I do and have no problem with.
2. I do and have a hard time with.
3. I used to do but avoid doing because I have a hard time with.
4. I don’t do and it’s not important.
5. I don’t do and it’s a problem and I miss it.


1. I go to movies.

2. I go to the theatre.

3 I go to music concerts: Indoor / Outdoor

4. I go to sports events: Indoor / Outdoor

5. I go to restaurants.

6. I meet friends at coffee shops.

7. I go to parties/ social events.

8. I entertain people at my own home.

9. I participate in church activities.

10. I participate in meetings.

11. I sing in a choir.

12. I play a musical instrument.

13. I play in a musical group.

14. I listen to the radio/stereo.

15. I watch TV on my own.

16. I watch TV with other people.

16. I participate in outdoor activities: walking group, hiking, golf, sport team, etc.

17. I drive with a group of people or am a passenger in a vehicle.

18. I talk on the phone: land line or cell phone: Pleasure / Business

19. I go shopping at the mall.

20. I use public transportation.

21. I travel by airplane, ferry, and train.

22. I work in a setting with other people.

23. I facilitate business meetings: Small groups / Large groups

24. I go to conferences.

25. I dance.