Want to save time at your appointment?

Fill out your patient intake paperwork online ahead of time

Want to save time at your appointment?

Fill out your patient intake paperwork online ahead of time

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.

Fill out, print, and bring your patient forms

Click buttons below to get the forms you need

Adult Information and History Form
Download
Personal Representative Form
Download
Companion Questionnaire
Download
Financial HIPAA Contact Form
Download
Medical Record Request Form
Download
Notice of Privacy Practices
Download
Pediatric Information and History Form
Download