Forms

NEW PATIENT INTAKE FORMS
Choosing the right hearing aid is key to improving your hearing. We invite all of our patients from Vacaville, Dixon, Fairfield and surrounding areas in California to complete the forms below and contact us at 707-317-1891 to schedule an appointment. Our office is conveniently located at 600 Nut Tree Road, Ste 250, Vacaville, CA and our friendly staff will be happy to assist everyone in Solano County.

Please download and print the following forms before your first visit.

Patient Registration

Notice of Privacy

HIPAA Acknowledgement

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