New Audiology Patient Paperwork
Professional Hearing Services offers our patient form(s) online so they can be completed in the convenience of your own home or office.
- All forms are PDF files. You will need AdobeReader® to view them.
- If you do not already have AdobeReader® installed on your computer,
Click Here to download. - Download the necessary form(s), print them out and fill in the required information.
- Bring the necessary form(s) to your appointment.
Adult Audiology History Form
Click to Download
Adult General History Form
Click to Download
Child General History Form
Click to Download
Financial Policies
Click to Download
Release of Information Request Form
Click to Download
Phone Request Form
Click to Download
Consent for Treatment
Click to Download
Resound Loss/Damage
Click to Download
Phonak Loss/Damage
Click to Download
Oticon Loss/Damage
Click to Download
Starkey Loss/Damage
Click to Download
Privacy Policy
Click to Download
OFFICE HOURS
Monday
8:00am - 5:00pm
Tuesday
8:00am - 5:00pm
Wednesday
8:00am - 5:00pm
Thursday
8:00am - 5:00pm
Friday
8:00am - 5:00pm
Saturday & Sunday
Closed
Moreland ENT
1111 Delafield St UNIT 102
Waukesha, WI 53188
Professional Hearing Services
1111 Delafield St #102A
Waukesha, WI 53188