Minimize your wait time

 
 

To help make your visit more pleasant and efficient, we have included the below forms so that you can print and fill them out prior to your appointment. Please speak to one of our friendly staff members for instructions on which form you need to bring. We are always standing by to answer any questions you may have!

 

New Patient Forms

Case History Form

Pediatric History Form

HIPPA Statement

HIPPA Privacy Practices Acknowledgement

Hearing Handicap Inventory – Screen Version HHIE-S

Abbreviated Profile of Hearing Aid Benefit

Client Oriented Scale of Improvement

New Patient Form

Spanish

Office Policies Form

Spanish

Case History for Auditory Processing Assessment in Children

Case History

Spanish

Office Policies

Privacy Practices Acknowledgement

Spanish

Pediatric History

Spanish