Patient Forms - The Hearing Center

Patient Forms

Patient Forms

Download our Patient Forms before your appointment. They are all printable from your own printer, but you must have the free Adobe Reader program to view the files.

If you don't have Adobe Reader, you can download a free version here.

Notice of Privacy

Download Patient Form here!
(8 pages, 148KB)
HIPAA Acknowledgement

Download Patient Form here!
(1 page, 84KB)
Record Release Authorization

Download Patient Form here!
(1 page, 52KB)
Patient Registration

Download Patient Form here!
(1 page, 48KB)
Patient Review of Systems

Download Patient Form here!
(1 page, 77KB)