Hearing Goals & Visit Prep Builder | UCSF EARS
Tool · Hearing Goals & Visit Prep Builder

Hearing Goals & Visit Prep Builder

Turn vague worries like “I miss things in groups” or “listening is exhausting” into a short, clear prep sheet you can bring to your audiology or ENT visit.

5–8 minutes Works on phones, tablets, and computers Helpful for adults, caregivers, and clinicians

This tool doesn’t triage emergencies and doesn’t replace medical care. It simply organizes what you want help with so you can use your visit time well. If you’re worried about sudden changes, pain, or new dizziness, use the Care Navigator or seek urgent care instead.

Build your visit story

Check a few boxes and jot a few words. You don’t need perfect language to get help—this is just a starting point you and your clinician can edit together.

Step 1
Who are you filling this out for?

This just tells the clinician whose voice this summary is trying to reflect.

Tip: Many caregivers and clinicians use “I” language in the visit, even if they helped fill this out. It’s all about what helps the patient feel most comfortable.

Step 2
Biggest listening situations that matter right now

Pick the situations where it would feel meaningful to have things go even a little bit better.

Where is listening hardest or most important?

Choose as many as apply. If nothing fits, use “Other.”

In your own words, what feels most important to improve?

A sentence or two is plenty: “I’d love to follow group conversations at work without pretending,” for example.

Step 3
What bothers you most about your hearing experience?

These are the parts people don’t always say out loud. You’re allowed to be honest here.

What shows up day to day?

Pick anything that sounds familiar—even if it doesn’t happen all the time.

Anything you wish your clinician really understood about this?

For example: “I feel guilty asking my partner to repeat” or “I’m scared this means I’ll lose my job.”

Step 4
What’s already been tried, and what support feels realistic?

This helps your clinician see the bigger picture and match next steps to where you are now.

What has been tried so far?

Check anything that applies—even if it “didn’t work” or wasn’t used for long.

What has helped (even a little)?

Include the small wins and the “this didn’t work at all” stories. Both are useful.

What kind of support feels realistic right now?

You don’t have to be ready for everything at once. It’s okay to ask for small steps.

Anything else about support, pacing, or timing?

For example: “I can’t make frequent visits,” “Cost is a big concern,” or “I’d like to move slowly.”