Please complete the following forms before your first visit to Mid-Valley Hearing Center. You can conveniently print and fill out these forms in advance to streamline your check-in process and ensure a smooth and efficient visit.
Please click on the links below to access the forms:
Our Patient Intake Form streamlines the onboarding process, ensuring a smooth and efficient experience. By providing us with essential details beforehand, we can focus on delivering exceptional care from the moment you step into Mid-Valley Hearing Center.
Our Adult Case History Form is meticulously designed to gather comprehensive information about your hearing health, empowering our expert audiologists to tailor personalized solutions for your specific needs.
Please complete this form if you are bringing a child for a hearing evaluation. It includes questions about the child’s medical history, development, and hearing-related concerns. Providing information will enable our team to provide the best care for your child.
Please note: To view and print these forms, you will need Adobe Acrobat Reader or a similar PDF viewer installed on your device.
If you need help accessing or printing the forms, please let us know; we will be happy to help you.
Thank you for choosing Mid-Valley Hearing Center. We appreciate the opportunity to serve you.