World Hum Map Survey Form (2.0)
www.thehum.info . SUBMIT THIS FORM ONLY ONCE! YOU MAY NEED TO WAIT SEVERAL MONTHS FOR YOUR DATA TO APPEAR ON THE HUM MAP. ALL YOUR ANSWERS WILL BE ANONYMOUS. You can contact Dr. MacPherson at glen.macpherson@gmail.com
What is your age? (Enter a number only) *
Your answer
Please describe the sound *
Your answer
How much effort have you put into looking for the source of the sound? *
What is your gender? *
Please list any scientific or technical training you have.
Your answer
Tell us where you hear the Hum (don't use your home address). Give country, city, and Postal Code/Zip Code. *
Your answer
What year did you first notice the Hum? *
Are you still hearing it today? *
In which ear is it loudest? *
Does the sound tend to start at a certain time of day? Explain. *
Your answer
Does the sound ever stop for minutes, hours, or days, or for longer periods? Please explain. *
Your answer
Please take a few moments to go here: http://onlinetonegenerator.com/ and adjust the frequency until it matches the tone of the Hum you here, and report that here. THIS IS EXTREMELY USEFUL INFORMATION.
Your answer
(OPTIONAL TECHNICAL QUESTION) If you answered the previous question, if you kept the tone generator volume low enough and used high quality speakers or one headphone, did you notice any "beating" or pulsing as the tones got close? This is the same type of thing you hear when you tune a guitar by playing two strings at once. Please explain.
Your answer
Please list symptoms, if any, caused by the sound (check all that apply)
If you shake your head very briefly, or exhale loudly, does the noise stop for about half a second and then quickly return?
Where is the sound loudest? *
When is the sound the loudest? *
Which is your strong hand? *
Have other people heard the same sound at the same time and in the same place as you? *
Will sounds like a bathroom fan or other background sounds mask the humming noise? *
Please state any medical conditions with your hearing, including Tinnitus. If you have tinnitus, please list the type if you know it. If you've had a hearing test, it would be very helpful if you included the specific results here.
Your answer
Are you, or have you been in the past a regular user of Advil (Ibuprofen), Tylenol (Acetaminophen), or Aspirin (ASA)?
Which of the following medications were you taking before the Hum appeared?
Have any of the following conditions been diagnosed or suspected in your parents, you, or siblings? Check all that apply. This information might be helpful, but of course this question is completely optional.
Have you ever been diagnosed with vertigo or balance problems?
You would describe yourself as...
Please try to recall what antibiotics you took during the time the Hum appeared, and after.
Your answer
Do you prefer low-calorie softdrinks or regular ones? Please estimate your consumption, in 330ml/11 fl.oz cans permonth.
Your answer
Would you consider yourself sensitive to sounds in general?
You live in ..
Does the sound change at all with the weather? Explain.
Your answer
Does the sound change at all with the seasons?
Your answer
Have you noticed any changes in the sound after air travel or being in the mountains? Please explain.
Your answer
Have you heard the noise in other places, cities, countries? Explain.
Your answer
Have you ever worked in loud environments such as construction, heavy industry, music performance and recording, and so on? Please explain.
Your answer
Did we forget to ask anything? Is there anything you'd like to add?
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms
Google Forms