Forms for our patients are included on this page. Please use the links below or the patient portal if you would like to fill them out before your appointment. You can bring the completed documents to your appointment or fax them to us at 360-551-4801.
HIPAA releases are also available if you need us to send your patient file to an outside office. Please contact our office if you have any questions about downloading or completing the documents below.
Forms for Adults
- Intake Forms for Adults: Demographic and medical information that will be requested at your first hearing test.
- Tinnitus forms: Additional questions for patients with tinnitus (ringing in the ears).
Forms for Children
A minor consent form is required for all pediatric patients: minor consent
Select the forms below that correspond to your child’s age. Each form contains demographic and medical information that will be requested at your child’s first hearing test.
- Newborns and infants (up to 6 months of age)
- Children 7 months to 3 years of age
- Children 3 years to 6 years of age
- Children older than 6 years of age
The forms below contain questionnaires for educators and for parents. These questionnaires help provide critical information about your child’s functional hearing and listening abilities at home and at school. Instructions for completing each questionnaire are included.