1. I get hoarse after teaching:
Daily
During a full week
By the end of the school year
Occasionally
Never

2. My hoarseness goes away:
Not applicable; I don't get hoarse.
Overnight
Over the weekend
Over the winter holiday/spring break/summer
Never

3. My voice gets fatigued from teaching:
Daily
Not every day, but more often than once a week
Once a week
Frequently
Never

4. My fatigue goes away:
Not applicable; I don't get fatigued.
Overnight
Over the weekend
Over Christmas/spring break/summer
Never

5. I speak loudly for a prolonged period of time:
Daily
More than twice a week
Once a week
Occasionally
Never

6. I drink 64 ounces or more of water:
Daily
At least a few days each week
Once a week
Occasionally
Never

7. The number of 8 oz. caffeinated beverages I drink daily is:
None
One or two (8-16 ounces)
Three or four (24-32 ounces)
Five or six (40-48 ounces)
More than six (more than 48 ounces)

8. The number of alcoholic beverages I consume on an average daily basis is:
None
One or two
Three or four
Five or six
More than six

9. The number of cigarettes I smoke a day:
None
One to five
Six to ten
Eleven to twenty
More than a pack a day

10. I have been smoking for:
Not applicable; I am not a smoker.
One to five years
Six to ten years
Between ten and twenty years
More than twenty years

11. I eat soon before going to bed:
Daily
Not every day, but more than once a week
Once a week
Occasionally (less than once per week)
Never

12. I wake up with a bitter taste in my mouth:
Daily
Not every day, but more than once a week
Once a week
Occasionally (less than once per week)
Never

13. My voice gets hoarse after I eat:
Daily
Not every day, but more than once a week
Once a week
Occasionally (less than once per week)
Never

14. I experience pain or discomfort from speaking (or singing):
Daily
Not every day, but more than once a week
Once a week
Occasionally (less than once per week)
Never

15. I shout over my students talking or singing:
Daily
Not every day, but more than once a week
Once a week
Occasionally (less than once per week)
Never

16. I have difficulty with my voice:
Daily
Not every day, but more than once a week
once a week
only when I'm sick
never

17. I have difficulty projecting my voice:
Daily
Not every day, but more than once a week
Once a week
Only when I'm sick
Never

18. I lose my voice:
Daily
Not every day, but more than once a week
Once a week
Only when I'm sick
Never

19. People comment about my voice (negatively):
Daily
Once a week
Once a month
Only occasionally
Never

20. I use electronic amplification when I teach:
Always
Once or twice per week
More than once a month, but less often than weekly
About once a month
Never

21. I feel that I can't teach effectively because of my voice:
All the time
Weekly
Monthly
Once in a while
Never

22. I clear my throat and/or cough:
All the time
Frequently
Occasionally
Only when I'm sick
Never

23. If I average my voice use for extracurricular activities (coaching, clubs, musicals, parenting) on a daily basis, I use my voice for these activities each day:
Zero to 1 hour
2-3 hours
3-4 hours
5-6 hours
More than 6 hours

24. I've considered changing professions because of my voice difficulties:
Never
Infrequently
Several times
Often
All the time

25. My throat hurts after I speak all day:
Every day
Not every day, but more than once a week
Weekly
Occasionally
Never