Hearing Center in Largo, FL

Patient Forms

To be Completed Prior to Appointment

Your trust is important to us. We take seriously the trust you have placed in us and we appreciate the opportunity to help you. We will do our utmost to live up to your expectations and make you feel comfortable during your visit.

Please complete both the personal and medical information forms. This will help to expedite your visit. If you are unable to complete the forms before your visit, please arrive 20 minutes prior to your appointment time so that your audiology appointment will not be delayed. The information is designed to ensure that you receive proper audiologic care at our office. We look forward to meeting you and to helping you Calm the Noise.

• Patient Information
• Tinnitus History Questionnaire
• Tinnitus Reaction Questionnaire
• Privacy Policy
• Privacy Policy