Personal TRQ Score


Tinnitus Treatment Center, LLC


Tinnitus Reaction Questionnaire (TRQ)


Name:
Date Completed:


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 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 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 as 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 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 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


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