Patient Forms

To help make your visit more pleasant and efficient, we have included the below forms so that you can print and fill them out prior to your appointment. Please speak to one of our friendly staff members for instructions on which form you need to bring. And of course, we are always standing by to answer any questions you may have!

Case History Form


HIPPA Privacy Practices Acknowledgement

68.1 kb

HIPPA Statement

170 kb

New Patient Forms

105 kb

Abbreviated Profile of Hearing Aid Benefit

64 kb

Hearing Handicap Inventory – Screen Version HHIE-S

51 kb

Client Oriented Scale of Improvement

36 kb

Pediatric History Form


Case History for Auditory Processing Assessment in Children


Office Policies

161 kb