Welcome to your Daily CI Listening & Bliss Check-In Name Email Phone What is your name or initials? Which side is your CI on? Choose one answer Left Right Bilateral None Listening Environments Today (select all that apply): Quiet room Noisy public space 1-on-1 conversation Group conversation Phone Outdoors Video call Rate your listening effort today (1 = effortless, 5 = extremely difficult) Effortless Mild Moderate High Extreme Effortless Extremely difficult Rate how fatigued did you feel after listening? Not tired A little during but it's over soon thereafter I can feel the tiredness, but it is not overwhelming and gone soon. The fatigue continues until I rest for a few minutes Very exhausted even with a little rest Not tired Very tired Emotional state right now (choose the closest) Please select your answer Calm Frustrated Tired Energized Anxious Proud Did anything surprise or delight you today in terms of sound? Did you experience any discomfort or device-related issues today? Yes No None If you selected Yes above please describe the issue: If you answered YES to the previous question, please describe the issue below. If not, feel free to skip.” Time's up Leave a Reply Cancel replyCommentEnter your name or username to comment Enter your email address to comment Enter your website URL (optional) Δ
