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.

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

If you are coming in for dizziness/VNG testing please fill out the 3 additional VNG forms.

Patient Intake Form
Download
Financial Policy
Download
Medication List
Download
HIPAA Brochure
Download
Pediatric Case History (Fill out if your child is 0-15 years of age)
Download
Adult Case History (ages 16+)
Download
Companion Questionnaire
Download
Consent to Release information TO Audiology, Inc.
Download
Consent to Release Information FROM Audiology, Inc.
Download
VNG Appointment Sheet
Download
VNG Instructions
Download
VNG Dizziness Questionnaire
Download