Patient Forms

Below you will find the registration paperwork and informational handouts that you receive when you schedule an appointment in our office.  Take a moment to download them now to complete and review them prior to your arrival.  This will save you time in our waiting room and allow us to serve you even faster!

Choose the paperwork from the appointment list below.  Please note: you will need the free .pdf reader Adobe Reader to view these forms, which can be downloaded here.

Adult Evaluation (ages 9 years old and up)

• Adult Patient Medical History Form

Pediatric Evaluation (newborn – 8 years)

• Pediatric Patient Medical History Form

Hearing Aid Evaluation

• General Medical History Form from above, age appropriate
• 5 Minute Hearing Test
• Hearing Aid Technology Pyramid
• Payment Options
• Most commonly asked questions & answers about hearing aids.
• Now Hear This by Cathie Gandel,  AARP Magazine
• Hearing Aid Expectations

Central Auditory Processing

• General Medical History Form from above, age appropriate
• Adolescent & Adult Auditory Processing History Form
• Pediatric Auditory Processing History Form
• Website on CAPD
• Please note: Additional paperwork may be necessary.  The office will inform you if needed.

Electronystagmography (ENG)

• General Medical History Form from above, age appropriate
• Vertigo History Form
• 5 Minute Balance Test
• Procedural Instructions
• Please note: Additional paperwork may be necessary.  The office will inform you if needed.