Voice Handicap Index The Voice Handicap Index Within the last month, how often did the following problems affect you? Check the appropriate response. 0 = Never, 4 = Always 1. My voice makes it difficult for people to hear me. 0 1 2 3 4 2. People have difficulty understanding me in a noisy room. 0 1 2 3 4 3. My voice difficulties restrict personal and social life. 0 1 2 3 4 4. I am left out of conversations because of my voice. 0 1 2 3 4 5. My voice problem causes me to lose income. 0 1 2 3 4 6. I feel as if I have to strain to produce voice. 0 1 2 3 4 7. The clarity of my voice is unpredictable. 0 1 2 3 4 8. My voice problem upsets me. 0 1 2 3 4 9. My voice problem makes me feel handicapped. 0 1 2 3 4 10. People ask, “What is wrong with your voice? 0 1 2 3 4