New Patient Forms | Hearing Loss Solutions
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Specializing In Tinnitus Treatment &
Care Beyond Hearing Aids

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Specializing In Tinnitus Treatment &
Care Beyond Hearing Aids

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Specializing In Tinnitus Treatment &
Care Beyond Hearing Aids

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Hearing Loss Solutions Patient Forms

New Patients Start Here

We look forward to beginning your healthy hearing journey! Prior to your initial visit, please take a moment to review, fill out, and print the appropriate forms below. Please bring the completed forms with you to your initial consultation. Feel free to call us at 818-989-9001 if you have any questions!

general health form

Financial Responsibility Agreement

hearing history form

Hearing Health History

hearing history form

Hearing Health Questionnaire

hearing history form

Patient Rights

hearing history form

Personal Injury History Form

hearing history form

Workers Compensation Initial History Intake Form

As one of the premier hearing centers in Sherman Oaks, CA, our Audiologist and team at Hearing Loss Solutions also provide 5-star-rated hearing care to patients from Encino, Beverly Hills, Studio City & Calabasas, CA, and surrounding areas.