New Patient Form

Did you know the incidence of hearing loss has doubled over the last 30 years?

Did you know the number one cause of hearing loss is exposure to excessive noise?

Did you know every other person over age 50 has difficulty understanding?

Did you know 65% of those with hearing loss are under age 65?

Did you know at least 20% of the population suffers from tinnitus, which is a ringing in the ears?

Did you know only 16% of doctors routinely screen for hearing loss?

Want to get a jump start on your New Patient paperwork? Simply print out the forms below, fill them out and bring them with you to your appointment.

Hearing Health Center New Patient Forms

New Patient Information Form Page 1

Hearing Health Center New Patient Forms for Pediatrics
pdf Pediatric New Patient Form Pages 1 & 2