Patient Forms

Get the most out of your better hearing consultation

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.

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

Got questions?

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