Name of Location that is "Looped" with an Assistive Hearing Loop: *
Your answer
Type of installed or portable hearing loop system(s) that connect wirelessly with the telecoil (T-coil) in my hearing aid(s), cochlear implant(s) or another type of personal hearing device. *
Required
Describe the space(s) where the assistive hearing loop is available to the public.
Your answer
Street Address of Location *
Your answer
Address: City *
Your answer
State *
Your answer
Zip Code *
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Main phone number for Location
Your answer
Is there at least one sign with the symbol for a Hearing Loop System at this location? *
How helpful was the hearing loop system - for clarity and comprehension at this location?
Not helpful at all
Extremely helpful
Clear selection
I connected to the hearing loop system in this space using this type of personal device. (Please check correct boxes.)
For information non hearing loop systems, visit https://www.hearingloss.org/programs-events/get-hearing-loop/. Would you like information sent to you about the Hearing Loss Association of America (HLAA) and/or the Get in the Hearing Loop Committee of HLAA (GITHL)? *
Required
A copy of your responses will be emailed to the address you provided.