Patient Forms

Before your first appointment, we ask that you fill out our New Patient Intake Form. You can click on the link below to download and print this form out at home, and then simply bring it with you to your first appointment. You are also welcome to arrive to your scheduled appointment 10 minutes early and fill this form out in our office.

New Patient Intake Form

If you are a Medicaid patient, please download and print the following form. You’ll need to bring it to your primary care doctor for an original signature, and then bring it to your first appointment with us in order to get proper coverage for your hearing care. If you’re unable to download or print this document, simply contact us to have us mail you a copy instead.

Medicaid Patients: Intake Form

• Patient Intake Form