Patient Forms

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.

Adult Case History Hearing

Download

Adult Medical History

Download

Adult Speech History

Download

Patient Demo Form

Download

Pediatric Medical History

Download

Pediatric Speech History

Download

Privacy Practices Acknowledgement

Download

Privacy Practices Full Disclosure

Download

Speech Therapy Contract

Download