Patient Forms and Insurance

For your convenience, please download and complete these forms before your visit.

Hearing Services

Audiology Intake/History Form

Vestibular History Form

Tinnitus History

Vestibular Test Instructions

Central Auditory Processing Questionnaire

Rehabilitation Services

Adult Intake - Physical/Occupational Therapy

Adult Speech therapy Patient Intake

Pediatric Intake

Voice therapy Questionnaire

Consent for Telehealth

Dizziness and Balance Services

Patient Information/Intake form

Medical History Form

Pre-Test Instruction

Fall Risk Questionnaire

Hearing Loss Questionnaire

Dizziness Symptom Profile

Dizziness Handicap Inventory

Online Bill Pay

For your convenience, you may pay your bill online:

Pay Your Bill Online