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Forms

All patients please download and fill out the following 3 forms:

Patient Information

Release of Medical Records

Electronic Mail Authorization

 

If you are being seen for a Hearing Evaluation and/or Hearing Aids you  will also need these 2 forms:

Hearing Instrument History and Needs Assessment

General History Form

 

If you are being seen for a Dizziness or Balance Evaluation you will also need these 3 forms:

Instructions for Dizzy Evaluation

Dizziness History Form

Dizziness Handicap Inventory

 

If you are being seen for a Tinnitus Evaluation you will also need these 4 forms:

Tinnitus Evaluation paperwork

Tinnitus TRQ

General History Form

TH Inventory