South County Hearing Services
South County Hearing Services
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    • Home
    • Services
    • What to expect
    • About Us/Reviews
    • Insurance & Hearing Aids
    • Hearing Instruments
    • Paperwork
    • Contact Us

  • Home
  • Services
  • What to expect
  • About Us/Reviews
  • Insurance & Hearing Aids
  • Hearing Instruments
  • Paperwork
  • Contact Us

Initial Paperwork

Patient History (pdf)Download
HIPAA (pdf)Download
Financial Disclosure and Release Form (pdf)Download

This is a survey about your hearing in various situations. Please fill it out and bring it with you.


Your hearing and ability to communicate also affects the people you interact with frequently. Please print a second copy of this survey and have a family/friend/frequent communication partner fill it out and bring it (and him/her!) with you to your appointment.

Personal Assessment of Communication Abilities (pdf)Download

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