Hearing Loss Solutions Patient Forms
New Patients Start Here
We look forward to beginning your healthy hearing journey! Prior to your initial visit, please take a moment to review, fill out, and print the appropriate forms below. Please bring the completed forms with you to your initial consultation. Feel free to call us at 818-989-9001 if you have any questions!
Financial Responsibility Agreement
Hearing Health History
Hearing Health Questionnaire
Patient Rights
Personal Injury History Form
Workers Compensation Initial History Intake Form
As one of the premier hearing centers in Sherman Oaks, CA, our Audiologist and team at Hearing Loss Solutions also provide 5-star-rated hearing care to patients from Encino, Beverly Hills, Studio City & Calabasas, CA, and surrounding areas.