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.

To fill out your patient form prior to your appointment, click the link to download the form(s) you need.

Please download, fill out, and print these forms

Companion Questionnaire
Download
Adult Case History
Download
Dizziness Questionnaire
Download
Intake Form
Download
Child Case History
Download
DPPHS Consent for Hearing Evaluation, Reporting, and Referral
Download
Retest Questionnaire
Download
VNG Pretest Instructions
Download