Forms

New Patients
At Adobe Hearing Center, we would like to make your initial check-in as carefree as possible. Therefore, we offer all new patients the option of downloading registration forms and completing them at home, prior to coming to the appointment. To take advantage of this convenience, please download a New Patient Packet, below:

Select New Patient Packet:

» Download Packet - Adult
» Download Packet - Pediatric (age 17 or under)

In accordance with federal regulation known as the HIPAA Privacy Rule, one of the forms included in the packet verifies that you have read Adobe Hearing Center's Notice of Privacy Practices (HIPAA). You may read it online by clicking on the link below, or you may request a copy in person on the day of your appointment.

Notice of Privacy Practices (HIPAA)

» Notice of Privacy Practices

 

Existing Patients

If you would like Adobe Hearing Center to send records to another physician or provider, please download this Release of Information form and mail it or fax it to Adobe Hearing Center.

» Authorization for Release of Information Form (coming soon...)
(This form is used when existing patients would like all past audiological records to be mailed to another healthcare provider.)

 

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