Patient Forms

We encourage you to fill 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(s) prior to your appointment, click the link to download the form(s) you need.

The following paperwork is needed for:

New Patients:

• Patient Intake Form
• HIPPA Privacy

Patient ‘s with Tinnitus also, complete:

• Tinnitus History Questionnaire
• Tinnitus Reaction Questionnaire

Established Patient’s: complete yearly.

• HIPPA Privacy

Continuing Care? – If seen elsewhere, have former office send pertinent information to help us take care of you.

• Medical Release