Patient Forms

Your First Appointment

Please print and complete these two new patient forms to bring to your initial appointment.  And read below about what to expect during your first appointment.

NOTE: The initial hearing screening is free.  There could be costs will be incurred for the hearing aids, ear molds, etc..  We always invite you to make a contribution to our fund that helps us cover the costs of the charitable work we conduct.

  • New Patient Intake Form
  • Hearing Comfort and Confidence Scale

    Your First Appointment
    • See your ears on TV
    • Complete ear exam and ear cleaning
    • Discuss hearing vs. understanding
    • Conduct hearing test and assessment
    • Review hearing aid options
    • Listen to personally programmed hearing aids
    • Consider a 4-6 week, no obligation trial with new hearing aids
    • Enjoy a home-baked treatA Hearing Aid Trial – The First Few Days
    • Enjoy hearing much better
    • Appreciate what you’ve been missing
    • Allow your brain to rehabilitate
    • Differentiate between foreground and background sounds
    • Practice using the hearing aid features for volume and settings
    • Gain more comfort and confidenceYour Ongoing Care and Service
    • 3 to 4 appointments during the 4-6 week trial
    • A 3-month follow-up appointment
    • Use a Bluetooth remote with TV, phones, and audio devices
    • Ongoing Semi-Annual or Annual appointments
    • While hearing aids are under warranty (1-5 years), we do not charge fees for in-office care and service.