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Public domain questionnaire

Tinnitus Screener

The six-question clinician-interview algorithm for describing tinnitus duration and temporal pattern.

Questions
6
Time
2 min
Privacy
Local only
Structured profile—not a diagnostic test.Tinnitus is ringing, buzzing, humming, or other noises in your ears or head. Answer for the past year. This is the interview-by-clinician version and its category is not a medical diagnosis. Source and rights.

Section 1

During the past year

01Have you experienced tinnitus lasting more than 2–3 minutes?
02Have you experienced tinnitus for at least 6 months?
03In a quiet room, can you hear tinnitus?
04When you heard tinnitus this past year, was it caused by a recent event? (Examples: loud concert, head cold, allergies, some medications)
05Does your tinnitus seem to ‘come and go’ on its own, in addition to being caused by a recent event(s)?
06Do you experience tinnitus on a:

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Source, rights, and limitations

Public domain. The 2023 reliability article marks the work In the Public Domain. The form is distributed by VA NCRAR. TinniTest presents it as a screening description, not a diagnosis.

TinniTest.org is independent. Citation and reproduction do not imply author, institution, publisher, VA, or government endorsement.