An Audiometer delivers sounds at different frequencies and loudness levels with a circum-aural headphone. The patient raises a hand, presses a button or says “yes” when he/she hears sounds. The audiologist records the responses on an audiogram. Pure-tone testing presents tones across the speech spectrum (500 to 8,000 Hz) to determine if the patient's hearing levels fall within normal limits. A quiet testing environment, calibrated audiometric equipment, and an audiologist are required for in-office testing. Pure-tone audiometry may help to appropriately refer patients to a clinical audiologist or otolaryngologist.