Advanced Hearing Center (duplicate)

1223 Lake Pointe Pkwy Sugar Land, TX 77478 (281) 491-0200 | Mon-Thurs 8-5pm | Fri 8-2pm
  • Healthy Hearing

"Professional Hearing and Balance Solutions"

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Forms

ADULT HEARING PATIENTS:
Patient Information 
Adult Audiology History
Patient Medications List
Assignment of Insurance Benefits
Records Release
Hearing Lifestyle Quiz
HIPAA Acknowledgement
HIPAA Notice

CHILD HEARING PATIENTS: 
Patient Information 
Pediatric Audiology History 
Your Child's Hearing History
Patient Medications List
Assignment of Insurance Benefits
Records Release
HIPAA Acknowledgement
HIPAA Notice  

VNG/BALANCE PATIENTS: 
Patient Information 
Adult Audiology History 
Dizziness Handicap Inventory 
Dizziness Questionnaire
VNG Guidelines
Patient Medications List
Assignment of Insurance Benefits
Records Release
HIPAA Acknowledgement
HIPAA Notice