4675 West 20th Street Road, Suite A, Greeley, Colorado 80634
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Patient Forms

formsCongratulations! Now that you’ve made your first appointment with Audiology Associates, we want the rest of the process to be a breeze. Please download and bring the completed New Patient Forms to your appointment so that you’re relaxed and not rushed when you arrive to our office. Please provide accurate and thoughtful responses to all questions so that we have a clear picture of your hearing health history when we meet with you. Should you have any questions about the form, please feel free to ask BJ over the phone.



forms2Tinnitus Reaction Questionaire (TQR)

© 2019 Audiology Associates. All right reserved. | Privacy Policy

The purpose of this hearing assessment and/or demonstration is for hearing wellness to determine if the client(s) may benefit from using hearing aids. Products demonstrated may differ from products sold. Test conclusion may not be a medical diagnosis. The use of any hearing aid may not fully restore normal hearing and does not prevent future hearing loss. Testing is to evaluate your hearing wellness, which may include selling and fitting hearing aids. Hearing instruments may not meet the needs of all hearing-impaired individuals. One offer per customer. Insurance benefit, including Managed Care or federal reimbursements, cannot be combined with any of our promotional offers, coupons or discounts. Other terms may apply. See office for details.