This project will compare implementation of three PCP-based hearing screening strategies that include progressive levels of PCP time and guidance to complete telephone-based hearing screening. Those who fail screening go on to a medical referral study and receive (1) diagnostic audiological testing and (2) determination of the reliability and validity of identification of conditions that should require medical referral prior to hearing aid provision (called FDA 'Red Flag' conditions, including conditions such as sudden hearing loss, cerumen impaction, conductive hearing loss, dizziness, external deformity, ear drainage). Adults between the ages of 65-75 years old who are being seen for a routine appointment at a participating Duke primary care site may be eligible to participate.