Forms

At House of Hearing Vernal, we offer a range of tailor-made options to support your hearing and improve your everyday life.

Please click on the links below to access the forms:

Patient Intake Form

You can utilize our Patient Intake Form for a convenient and streamlined process. By providing us with essential information in advance, we’re prepared to offer you excellent care from the moment you step into House of Hearing Vernal.

Adult Case History Form

Our Adult Case History Form is designed to gather comprehensive information about your hearing. This valuable data assists our experienced ear professionals in creating a customized plan that suits your specific needs.

Please note: To view and print these forms, you will need Adobe Acrobat Reader or a similar PDF viewer installed on your device.

Please let us know if you need help accessing or printing the forms; we will be happy to help you.

Thank you for choosing House of Hearing Vernal. We appreciate the opportunity to serve you.