To get the most out of your better hearing consultation, please fill out these forms and print them to bring with you to your appointment.

We encourage you to fill out your paperwork prior to your appointment—it can help save you time when you check in to our office, spur important conversations between you and your loved ones, and get you thinking about your better hearing goals.

All Patients: HIPAA Policy for your review, no need to print.

 

All New Patients: Please fill out the following forms.

  • Patient Information Form
  • Hearing Health Questionnaire

 

All New Medicare Patients: Please fill out the following forms.

  • Patient Information Form
  • Hearing Health Questionnaire
  • Medication Form

 

All New Tinnitus Evaluation Patients: Please fill out the following forms.

  • Patient Information Form
  • Hearing Health Questionnaire
  • Tinnitus Program Outline
  • Tinnitus Questionnaire
  • Depression Inventory

 

Patient Information Form
Download
Hearing Health Questionnaire
Download
Medication Form
Download
Tinnitus Program Outline
Download
Tinnitus Questionnaire
Download
Depression Inventory
Download
HIPAA Policy
Download