Initial Tinnitus Assessment
Please answer all questions to the best of your ability.

If you provide your e-mail, you will be contacted by a tinnitus expert about your initial assessment. Further assessments and consultation are included in a purchased sound therapy package.

If you have any questions, please email us at or call us at 1-866-688-3772
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy