Symptoms Score (VoiSS) My voice makes it difficult for people to hear me 0 1 2 3 4My voice makes it difficult for people to hear me 0 1 2 3 4I run out of air when I talk 0 1 2 3 4People have difficulty understanding me in a noisy room 0 1 2 3 4The sound of my voice varies throughout the day 0 1 2 3 4My family has difficulty hearing me when I call throughout the house 0 1 2 3 4Iuse the phone less often than I would like 0 1 2 3 4I’m tense when talking with others because of my voice 0 1 2 3 4I tend to avoid groups of people because of my voice 0 1 2 3 4People seem irritated with my voice 0 1 2 3 4People ask, “What’s wrong with your voice?” 0 1 2 3 4I speak with friends, neighbours or relatives less because of my voice 0 1 2 3 4People ask me to repeat myself when speaking face to face 0 1 2 3 4My voice sounds creaky and dry 0 1 2 3 4I feel as though I have to strain to produce my voice 0 1 2 3 4I find other people don’t understand my voice problem 0 1 2 3 4My voice difficulties restrict my personal and social life 0 1 2 3 4The clarity of my voice is unpredictable 0 1 2 3 4I try to change my voice to sound different 0 1 2 3 4I feel left out of my conversation because of my voice 0 1 2 3 4I use a great deal of effort to speak 0 1 2 3 4My voice is worse in the evening 0 1 2 3 4My voice problem causes me to lose income 0 1 2 3 4My voice problem upsets me 0 1 2 3 4I am less outgoing because of my voice problem 0 1 2 3 4My voice makes me feel handicapped 0 1 2 3 4My voice ‘gives out on me’ in the middle of speaking 0 1 2 3 4I feel annoyed when people ask me to repeat myself 0 1 2 3 4I am embarrassed when people ask me to repeat myself 0 1 2 3 4My voice makes me feel incompetent 0 1 2 3 4I’m ashamed of my voice problem 0 1 2 3 4 Name DOB Email Phone number Please contact me by email Please contact me by phone Time is Up!
