Patient Intake Form

Your browser does not support iframes. <a href="https://secureform.luxsci.com/forms/13207/6144/e3yA/form.html" target="_blank">Click here</a>

Elizabeth T.

"I have worn hearing aids for over ten years. I was unable to hear my family and unable to discern...

Elizabeth T.,
Patient

"I was having difficulty hearing sounds and not being able to distinguish words. I was especially having difficulty in noisy...

Jeri H.,
Patient

"My wife and I want to express thanks to your staff for competence along with the pleasant work attitude as...

Dave and Jean M.,
Patient