Tool · Tinnitus Functional Index

Tinnitus Functional Index (TFI)

When tinnitus is bothersome, this 25-item questionnaire describes its impact across eight areas of daily life. Use the results to focus management discussions and track change over time. This is the third questionnaire in the tinnitus pathway, not a requirement for receiving care.

About 8–10 minutes 25 questions 8 subscales

A patient-reported baseline: The TFI measures tinnitus impact over the past week on a 0–100 scale. It helps you and your clinician identify priorities; it does not diagnose a condition or decide eligibility for care.

If you have not yet identified whether tinnitus is bothersome, start with the Tinnitus & Hearing Survey. Use Tinnitus Triage for evaluation timing. For urgent symptoms or crisis support, use the Emergency Safety Guide now. Do not delay urgent care to finish a questionnaire.

Sound sensitivity? Get guidance now. Pain or difficulty tolerating sound deserves attention alongside tinnitus care.

Your tinnitus questionnaire pathway

Start with timing, then identify what is difficult. Complete the TFI when tinnitus is bothersome; you do not need every questionnaire to receive care.

Sound sensitivity matters from the start. Tell your clinician if sound causes discomfort or pain. The survey’s third section asks about sound tolerance. Get sound-sensitivity guidance at any stage.

Questionnaires help prepare for care. Arrange appropriate evaluation and access education or support alongside them. Urgent symptoms always take priority.

Optional: watch the overview

Watch video on Canva (opens in new window) ↗

Prefer to read? Video key points & text summary (no audio needed)

Medical & Crisis Safety First: Seek urgent medical care for sudden hearing loss (especially rapid drops over hours to days), pulsatile (heartbeat-synced) or one-sided tinnitus, or severe vertigo—and call or text 988 for immediate crisis support; see the Emergency Guide. Urgency does not expire after 72 hours.
What the TFI Measures: Developed by Meikle et al. (2012), this 25-item clinical tool rates your past week from 0 to 100 across 8 subscales (Intrusiveness, Sense of Control, Concentration, Sleep, Auditory, Relaxation, Quality of Life, and Emotional/Mood).
From Subscales to Action: A drop of ~13 points over time shows meaningful improvement; bring your 0–100 baseline and highest subscales to your audiologist, ENT physician, or CBT specialist.

Video Transcript (0:00–1:00):

0:00–0:08: Wondering which areas of your life tinnitus affects most? The Tinnitus Functional Index, or TFI, gives you a clear zero-to-one-hundred clinical baseline.
0:08–0:17: First, check for urgent symptoms. Seek prompt medical care for sudden hearing loss (rapid drop over hours to days), heartbeat-synced or one-sided tinnitus, or severe vertigo—and call or text 988 if you feel overwhelmed or unsafe.
0:17–0:26: As you answer the 25 questions below, think about your typical experience over the past week across eight domains—including sleep, concentration, relaxation, hearing, and mood.
0:26–0:36: Your total score from zero to one hundred shows overall impact, and repeating the TFI over time helps track real progress—where a thirteen-point drop marks meaningful improvement.
0:36–0:45: Just as important is your subscale breakdown, which pinpoints whether to start with bedside sound enrichment for sleep, ambient audio for focus, or a hearing test.
0:45–0:53: You can save or print your TFI breakdown to share with an audiologist, an ENT physician, or a cognitive behavioral therapist.
0:53–1:00: Scroll down right below this video to rate your past week and get your personalized TFI score and action plan.

Rate your experience over the past week

Think about your typical experience over the last 7 days. There are no right or wrong answers. Choose the number (0 to 10) that best describes your experience.

Section 1 of 8 · Intrusiveness (I)

Awareness & Loudness

Over the past week, rate how noticeable and strong your tinnitus felt on a 0–10 scale.

1. What percentage of your time awake were you consciously AWARE of your tinnitus?

2. How STRONG or LOUD was your tinnitus?

3. What percentage of your time awake were you ANNOYED by your tinnitus?

Section 2 of 8 · Sense of Control (SC)

Coping & Control

Over the past week, rate how manageable your tinnitus felt.

1. Did you feel IN CONTROL in regard to your tinnitus?

2. How easy was it for you to COPE with your tinnitus?

3. How easy was it for you to IGNORE your tinnitus?

Section 3 of 8 · Cognitive Interference (C)

Focus & Thinking

Over the past week, rate how much tinnitus interfered with your mental focus.

1. How much did your tinnitus interfere with your ability to CONCENTRATE?

2. How much did your tinnitus interfere with your ability to THINK CLEARLY?

3. How much did your tinnitus interfere with your ability to FOCUS ATTENTION on other things?

Section 4 of 8 · Sleep Disturbance (SL)

Sleep Quality & Rest

Over the past week, rate how much tinnitus affected your nighttime rest.

1. How often did your tinnitus make it difficult to FALL ASLEEP or STAY ASLEEP?

2. How often did your tinnitus cause difficulty getting AS MUCH SLEEP as you needed?

3. How much of the time did your tinnitus keep you from SLEEPING as DEEPLY or PEACEFULLY as you would have liked?

Section 5 of 8 · Auditory Difficulties (A)

Hearing & Speech Clarity

Over the past week, rate how much tinnitus interfered with your hearing abilities.

1. How much has your tinnitus interfered with your ability to HEAR CLEARLY?

2. How much has your tinnitus interfered with your ability to UNDERSTAND PEOPLE who are talking?

3. How much has your tinnitus interfered with your ability to FOLLOW CONVERSATIONS in a group or noisy environment?

Section 6 of 8 · Relaxation Interference (R)

Rest & Quiet Time

Over the past week, rate how much tinnitus interfered with your downtime and relaxation.

1. How much has your tinnitus interfered with your QUIET RESTING ACTIVITIES?

2. How much has your tinnitus interfered with your ability to RELAX?

3. How much has your tinnitus interfered with your ability to enjoy PEACE AND QUIET?

Section 7 of 8 · Quality of Life (Q)

Activities, Work & Relationships

Over the past week, rate how much tinnitus interfered with your social and daily life.

1. How much has your tinnitus interfered with your enjoyment of SOCIAL ACTIVITIES?

2. How much has your tinnitus interfered with your ENJOYMENT OF LIFE?

3. How much has your tinnitus interfered with your RELATIONSHIPS with friends, family, and other people?

4. How often did your tinnitus cause difficulty performing your WORK OR OTHER TASKS?

Section 8 of 8 · Emotional Distress (E)

Mood & Emotional Well-being

Over the past week, rate how much emotional distress you experienced because of your tinnitus.

1. How ANXIOUS or WORRIED has your tinnitus made you feel?

2. How BOTHERED or UPSET have you been because of your tinnitus?

3. How DEPRESSED were you because of your tinnitus?

Your TFI Score

Clinical impact baseline & functional breakdown

TFI 0–100

UCSF Department of Otolaryngology — Head & Neck Surgery

Tinnitus Functional Index (TFI) Assessment Report

Validated 25-Item Clinical Protocol (Meikle et al., 2012) · UCSF EARS Educational Platform

Complete Sections 1–8

As you answer each section on the left, your personalized 0–100 TFI baseline, 8-domain functional chart, and targeted care steps will be calculated here.

Your responses remain completely private on your device.

Clinical Note: This assessment tool provides an educational baseline to help structure discussions with your audiologist, ENT physician, or behavioral therapist. It does not replace a diagnostic audiological evaluation or medical workup.

Building your tinnitus care team

Wherever you live, effective tinnitus care combines thoughtful medical and audiological evaluation, evidence-based coping skills, sound enrichment, and dedicated support for sleep and mood.