Up to $595+ NY Hearing Study

About the study

Thank you for your interest in the Audiology Study coming to NYC!

Should you qualify, you will attend an in-person session in Manhattan where you will complete an audiological exam and determine eligibility in the study. The on-site session can last up to 4hrs depending on qualification:

Screen-out: 1hr - $100
Proceed to complete study 1: 2hr - $200
Proceed to complete study 2 (+ at-home portion): 3.5-4hr - $595

For those that make it to complete study 2, you will take home a piece of equipment to use 30 mins/day for 30 days. After those 30 days, you will be asked to drop the device off and will be eligible for full payment.

We look forward to having you participate and thank you again for your interest and time!

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* 1. Contact Info

Full Name:

Email:

Phone:

Gender:

Age:

City, State:

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* 2. What is your date of birth?

DOB

Date

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* 3. Are you able to read and understand English?

Yes

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* 4. What is your:

Job Title:

Industry:

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* 5. Which of the following best describes your ethnicity?

East Asian (includes Chinese, Japanese, Korean)

South Asian (includes Asian Indian, Pakistani, Bangladeshi)

Southeast Asian (includes Cambodian, Filipino, Thai, Vietnamese)

Black, African American, or African (includes African American, Barbadian, Caribbean, Ethiopian, Ghanian, Haitian, Jamaican, Liberian, Nigerian, Somali, South African)

Hispanic, Latino, or Spanish (includes Colombian, Cuban, Dominican, Ecuadorian, Honduran, Mexican or Mexican American, Puerto Rican, Salvadoran, Spanish)

Middle Eastern or North African (includes Afghan, Algerian, Egyptian, Iranian, Iraqi, Israeli, Lebanese, Moroccan, Syrian, Tunisian)

Native Hawaiian or other Pacific Islander (includes Chamorro, Chuukese, Fijian, Marshallese, Native Hawaiian, Palauan, Samoan, Tahitian, Tongan)

American Indian or Alaska Native (includes Central or South American Indian)

White (includes Dutch, English, European not listed, French, German, Irish, Italian, Norwegian, Polish, Scottish)

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* 6. Do any of the following apply regarding your hearing? Note: if you have hearing loss but it has not been diagnosed by a doctor, please select "None of the above".

Diagnosed conductive hearing loss, mixed hearing loss, or central auditory processing disorder

An existing hearing assistive device (i.e. cochlear implant, bone-anchored hearing aid, or middle ear implant)

History of ear pain or discomfort, chronic ear infections, or ear drainage that could interfere with my ability to wear and use a hearing aid

A typical ear physiology or prior surgery that could impact my ability to wear and use a hearing device

None of these apply to my hearing

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* 7. Do you have any of the following? Check all that apply.

Profound hearing loss, complete hearing loss, or total inability to hear

Active ear infection or ear pain

Tinnitus that impacts daily life

Acute or chronic vertigo or dizziness

Sudden hearing loss in the preceding 90 days

Cochlear implant

None of these

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* 8. Are you able and willing to sit in an enclosed sound booth for up to 1 hour?

Yes

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* 9. Have you participated in a hearing study previously?

Yes

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* 10. Are you currently participating in a clinical trial?

Yes

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* 11. Are you currently taking any prescription medications?

Yes

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* 12. Do you have any hearing loss that you are aware of?

No hearing loss

Mild hearing loss

Moderate hearing loss

Severe hearing loss

Unsure