Patient Forms


Confidential Patient Information Form Confidential Patient Information Form
This form requests information about yourself, medical history and hearing history
Patient Questionnaire, Pre-Fitting Form Patient Questionnaire, Pre-Fitting Form
This form ask questions about your everyday hearing experiences
Patient Authorization Release Form Patient Authorization Release Form
This form is optional. We think it is important to keep your Primary Care Physician "in the loop" regarding your hearing health. With your consent, we will provide your hearing evaluation results to your primary care physician.

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Client's Testimonials

"Take it from me Walter Furley, you can trust the good people at the Hearing Aid Company of Texas."
- Walter Furley - Former KZTV News Anchorman

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Corpus Christi

6468 Holly Rd.
Corpus Christi, TX 78412

Phone: (361) 356-4003
Fax: (361) 814-3490
Toll Free: (800) 571-3058