Voice Handicap Index (VHI)"*" indicates required fieldsName*Please list your legal name if we are seeking insurance reimbursement. First Last What's your email?*Who's Your Clinician?* Kevin Ry Emily AC Robin GregPart 1: FunctionalMy voice makes it difficult for people to hear me* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysPeople have difficulty understanding me in a noisy room* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysMy family has difficulty hearing me when I call them throughout the house* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysI use the phone less often than I would like to* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysI tend to avoid groups of people because of my voice* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysI speak with friends, neighbors, or relatives less often because of my voice* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysPeople ask me to repeat myself when speaking face-to-face* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysMy voice difficulties restrict my personal and social life* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysI feel left out of conversations because of my voice* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysMy voice problem causes me to lose income* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysPart II- PhysicalI run out of air when I talk* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysThe sound of my voice varies throughout the day* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysPeople ask, “What’s wrong with your voice?”* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysMy voice sounds creaky and dry* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysI feel as though I have to strain to produce voice* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysThe clarity of my voice is unpredictable* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysI try to change my voice to sound different* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysI use a great deal of effort to speak* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysMy voice is worse in the evening* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysMy voice “gives out” on me in the middle of speaking* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysPart III- EmotionalI am tense when talking to others because of my voice* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysPeople seem irritated with my voice* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysI find other people don’t understand my voice problem* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysMy voice problem upsets me* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysI am less outgoing because of my voice problem* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysMy voice makes me feels handicapped* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysI feel annoyed when people ask me to repeat* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysI feel embarrassed when people ask me to repeat* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysMy voice makes me feel incompetent* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- AlwaysI am ashamed of my voice problem* 0- Never 1- Almost Never 2- Sometimes 3- Almost Always 4- Always
