New Patient Paperwork

Professional Hearing Services offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer,
    Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Bring the necessary form(s) to your appointment.

  • Adult Audiology History Form

    Click to Download

  • Adult History Form

    Click to Download

  • Child History Form

    Click to Download

  • Release of Information Request Form

    Click to Download

  • Phone Request Form

    Click to Download

  • Resound Loss/Damage

    Click to Download

  • Phonak Loss/Damage

    Click to Complete

  • Oticon Loss/Damage

    Click to Complete

  • Starkey Loss/Damage

    Click to Complete

  • Privacy Policy

    Click to Complete

OFFICE HOURS

Monday
8:00am - 5:00pm

Tuesday
8:00am - 5:00pm

Wednesday
8:00am - 5:00pm

Thursday
8:00am - 5:00pm

Friday
8:00am - 5:00pm

Saturday
Closed

Click Here for more locations and office hours

Professional Hearing Services

1111 Delafield Street #102A
Waukesha, WI 53188

(262) 549-5150