Sound Answers was approached by a medical technology provider for help in modifying alarm sounds for a formal jury test. The jury test had the requirement that the sounds must be heard as they would be heard in a realistic environment, and as if the listener were in specific positions within the room. The alarm sounds as presented to Sound Answers were recorded independent of any ambient noise or environment, so the goal of this project is to synthesize sounds that are true to a realistic environment. Ambient noise recordings and impulse response (IR) functions were measured in a medical clinic facility. The ambient recordings were used to provide the “background” in the synthesized sounds, where the IR functions were used to simulate the listener position within the room for each recording. The sounds were synthesized and used to develop a MATLAB based playback toolbox for the customer to use in the jury facilitation.