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> Voice Handicap Index – 10 Self Rating Form
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Voice Handicap Index – 10 Self Rating Form
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Voice Handicap Index - 10 Self Rating From
Name
*
First
Last
Date of Birth
*
Date
*
DD slash MM slash YYYY
Name of Clinician
*
Status of Therapy
*
Pre-therapy
Post-therapy
Instructions
These are statements that many people have used to describe their voices and the effects of their voices on their lives. Tick the response that indicates how frequently you have the same experience.
My voice makes it difficult for people to hear me.
*
Never
Almost never
Sometimes
Almost always
Always
I run out of air when I talk.
*
Never
Almost never
Sometimes
Almost always
Always
People have difficulty understanding me in a noisy room.
*
Never
Almost never
Sometimes
Almost always
Always
The sound of my voice varies throughout the day.
*
Never
Almost never
Sometimes
Almost always
Always
My family has difficulty hearing me when I call them throughout the house.
*
Never
Almost never
Sometimes
Almost always
Always
I use the phone less often than I would like.
*
Never
Almost never
Sometimes
Almost always
Always
I tend to avoid groups of people because of my voice.
*
Never
Almost never
Sometimes
Almost always
Always
People seem irritated with my voice.
*
Never
Almost never
Sometimes
Almost always
Always
People ask, “What’s wrong with your voice ?”
*
Never
Almost never
Sometimes
Almost always
Always
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