Forms
We want your first visit to be as smooth and efficient as possible. To help with this, please complete our patient form in advance. Simply download the form, fill it out, and email the completed PDF to [email protected], or bring a printed copy with you to your appointment. This ensures we can focus more on your care and less on paperwork.
Hearing Health Report (Adult)
To make the best use of your time at your first appointment, please complete the form in advance. Email the completed PDF to [email protected], or bring a printed copy to your appointment.
Hearing Health Report (Pediatric)
To make the best use of your time at your first appointment, please complete the form in advance. Email the completed PDF to [email protected], or bring a printed copy to your appointment.
Hearing Handicap Inventory for Adults (HHIA)
This inventory provides us with a better understanding of the impacts and difficulties faced due to hearing loss.
Vestibular Testing Intake Form
Completing this form prior to your vestibular testing appointment allows us to better understand your symptoms and your struggles.
Release of Patient Information Form
In some cases we require additional information from your Primary Care Physician and/or your Ear, Nose & Throat (ENT) Doctor in order to provide the best possible care for you. This form requests information to be sent from your doctor to Hearing Doctors.
Forms
We want your first visit to be as smooth and efficient as possible. To help with this, please complete our patient form in advance. Simply download the form, fill it out, and email the completed PDF to [email protected], or bring a printed copy with you to your appointment. This ensures we can focus more on your care and less on paperwork.
Hearing Health Report (Adult)
To make the best use of your time at your first appointment, please complete the form in advance. Email the completed PDF to [email protected], or bring a printed copy to your appointment.
Hearing Health Report (Pediatric)
To make the best use of your time at your first appointment, please complete the form in advance. Email the completed PDF to [email protected], or bring a printed copy to your appointment.
Hearing Handicap Inventory for Adults (HHIA)
This inventory provides us with a better understanding of the impacts and difficulties faced due to hearing loss.
Vestibular Testing Intake Form
Completing this form prior to your vestibular testing appointment allows us to better understand your symptoms and your struggles.
Release of Patient Information Form
In some cases we require additional information from your Primary Care Physician and/or your Ear, Nose & Throat (ENT) Doctor in order to provide the best possible care for you. This form requests information to be sent from your doctor to Hearing Doctors.
Forms
We want your first visit to be as smooth and efficient as possible. To help with this, please complete our patient form in advance. Simply download the form, fill it out, and email the completed PDF to [email protected], or bring a printed copy with you to your appointment. This ensures we can focus more on your care and less on paperwork.
Hearing Health Report (Adult)
To make the best use of your time at your first appointment, please complete the form in advance. Email the completed PDF to [email protected], or bring a printed copy to your appointment.
Hearing Health Report (Pediatric)
To make the best use of your time at your first appointment, please complete the form in advance. Email the completed PDF to [email protected], or bring a printed copy to your appointment.
Hearing Handicap Inventory for Adults (HHIA)
This inventory provides us with a better understanding of the impacts and difficulties faced due to hearing loss.
Vestibular Testing Intake Form
Completing this form prior to your vestibular testing appointment allows us to better understand your symptoms and your struggles.
Release of Patient Information Form
In some cases we require additional information from your Primary Care Physician and/or your Ear, Nose & Throat (ENT) Doctor in order to provide the best possible care for you. This form requests information to be sent from your doctor to Hearing Doctors.
Acknowledgment of Notice of Privacy Practices
The Health Insurance Portability and Accountability Act (HIPAA) requires us to provide patients or their power of attorney (POA) with our Notice of Privacy Practices, and to obtain their signature to acknowledge that they have received it. Providing your digital signature takes approximately 1 minute and doesn’t require any special software.
Request a Callback
If you have a question, a concern, or would like a second opinion, our team is here to help. Simply complete the form and a member of our team will call you shortly for a friendly, no-obligation conversation.
Alternatively, you can book an appointment online today.
Request a Callback
If you have a question, a concern, or would like a second opinion, our team is here to help. Simply complete the form and a member of our team will call you shortly for a friendly, no-obligation conversation.
Alternatively, you can book an appointment online today.
Request a Callback
If you have a question, a concern, or would like a second opinion, our team is here to help. Simply complete the form and a member of our team will call you shortly for a friendly, no-obligation conversation.
Alternatively, you can book an appointment online today.