Tinnitus Reaction Questionnaire (TRQ)

This questionnaire is designed to find out what sort of effects tinnitus has had on
your lifestyle, general well-being, etc. Some of the effects below may apply to you,
some may not. You must answer all questions. Choose the answer that best
reflects how your tinnitus has affected you over the past week.

Customer Details

Please enter your name, date of birth and whether you'd like a copy of your answers and result.

Patient Email (not Clinician email)

Patient Date of Birth

My tinnitus has made me unhappy.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has made me feel tense.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has made me feel irritable.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has made me feel angry.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has led me to cry.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has led me to avoid quiet situations.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has made me feel less interested in going out.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has made me feel depressed.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has made me feel annoyed.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has made me feel confused.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has "driven me crazy".

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has interfered with my enjoyment of life.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has made it hard for me to concentrate.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has made it hard for me to relax.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has made me feel distressed.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has made me feel helpless.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has made me feel frustrated with things.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has interfered with my ability to work.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has led me to despair.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has led me to avoid noisy situations.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has led me to avoid social situations.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has made me feel hopeless about the future.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has interfered with my sleep.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has led me to think about suicide.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has made me feel panicky.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

My tinnitus has made me feel tormented.

Not at all

A little of the time

Some of the time

A good deal of the time

Almost all of the time

Tinnitus Reaction Questionnaire (TRQ)

Customer Details

Questions

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