🧠Welcome to your CI Empowerment Survey! This space is designed for cochlear implant users like you to share your experiences, challenges, and ideas to shape the future of hearing wellness together. Your insights will help us build meaningful tools, resources, and community support tailored to real needs. Participation is voluntary, responses are anonymous unless you choose to share your contact info, and all answers will be kept confidential. We’ve prioritized visual clarity and accessibility so the survey is comfortable to complete. There are no right or wrong answers—only your truth. 💬 Let's begin, and thank you for lending your voice to this growing movement. Name Email Type of CI & Years of Usage What listening situations are most difficult for you? Group conversations Restaurants or cafés Phone calls Outdoor environments Watching TV or media Other (please specify) None Comment If you selected ‘Other’ in the previous questions, please let us know in the box below. Otherwise, skip this field Which type of background noise affects you most? Music Loud chatter Traffic noise Mechanical sounds (e.g., air conditioning) I’m not sure None Comment Have you found any strategies or tools that help? Describe briefly. On a typical day, how mentally tiring is listening with your CI? Not tiring Mildly tiring Moderately tiring Very tiring Extremely tiring None Comment Would you be interested in wellness resources like mindfulness, meditation, relaxation techniques, sound therapy, or cognitive support? Please select your answer No Yes I'm not sure right now Comment What activities help you feel balanced or supported in your hearing journey? Do you currently use mobile apps, accessories, or other tech tools alongside your CI? techniques, sound therapy, or cognitive support? Please select your answer No Yes I'd like to, but don't know how Comment Would you like to connect with other CI users in a support group or online forum? Please select your answer No Yes I'd like to, but don't know how I'm not sure right now Comment Are you interested in contributing ideas or helping build this platform as a volunteer? Writing or editing Outreach or organizing Technology or applications Moderating discussion Administration Social media posting Media creation Site development or management Public relations Not right now Comment Is there anything else you'd like to share, please do so here? What other questions or topics would you like to see included in this survey? How do you manage in education or workplace settings? I have no issues Find it difficult to focus Distracted by too many sounds I feel stress from trying to hear clearly Other None Comment How do family, friends, and coworkers respond to your hearing needs? They know my needs and help me. My family don't try to include me in conversations. My coworkers don't try to include my active participation. My friends forget to include me during social conversations. Other Comment What invisible barriers or discrimination have you faced? Comment Have you faced exclusion in talent-based opportunities because of hearing loss? None at all Sometimes Most often None Comment What kind of support do you wish existed for CI users with creative passions? Comment 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
