Daily COVID-19 Hearing Diary Please record your current problems with hearing Please enable JavaScript in your browser to complete this form.Date / TimeDateTimeDate & time for hearing entries made throughout the dayCheck All that ApplyHearing Loss-significantHearing loss-minorTinnitus-Ringing in EarsEar PainLoss of TasteLoss of SmellAbnormal Blood PressureAbnormal PulseFog-ConfusionOn Scale of 1-10 Rate Impact on Quality of Life Due to Hearing AbnormalitiesRate 1 out of 10Rate 2 out of 10Rate 3 out of 10Rate 4 out of 10Rate 5 out of 10Rate 6 out of 10Rate 7 out of 10Rate 8 out of 10Rate 9 out of 10Rate 10 out of 10Please enter your hearing disability and its impact on your ability to function normally; 1 being not a problem to 10 being serious disruption.Please Describe Any Changes or Problems That Have Arisen Concerning Your Hearing Since Last EntrySubmit