Patient Forms

Patient Intake & Information

To be completed only if patient prefers not to use our online pre-registration portal

• Patient Medical History
• Financial Policies and Consents
• Minor Consent

Align Hearing Centers

for Audiology and Hearing Aid Appointments

• Tinnitus History Questionnaire
• Tinnitus Reaction Questionnaire

Patient Privacy

• Authorization for Release of Medical Information
• Notice of Privacy Practices

Allergy

• Allergy Test Instructions & Questionnaire