Patient Forms

Download and complete these forms before your visit to save time and help us better understand your hearing health history and communication goals.

Patient Information Form

Adult Hearing Health History Form

Child Hearing Health History Form

Patient Medication Form

Authorization and Disclosure Form

Advanced Beneficiary Notice of Noncoverage

Email and Text Consent Form

The care you need from Audiologists you trust

12911 120th Ave NE, Suite E40
Kirkland, WA 98034

425-821-6600