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Patient Forms

Treatment Paperwork
Please complete these forms before your visit.
Choose the paperwork for your appointment type.

Balance Evaluation and Instructions - adults and children over age five with dizziness, vertigo, poor balance, risk of falling, vestibular migraines and motion intolerance

Audiological (Hearing) Evaluation - adults and children over age 5

Lyric Evaluation - patients considering the Lyric Extended Wear Hearing Device

Tinnitus Evaluation - patients with ringing/roaring in the ears or other head noises

Pediatric Audiological (Hearing) Evaluation - children under age 5

Pediatric Vestibular Eval uation - children under age 5 with dizziness, vertigo, migraine, poor balance, visual-spatial problems

Newborn Evaluation and Testing

Information

General Information About the Institute

Information About Inner Ear Disorders, Vertigo and Balance

 

Provider Form

Physicians Referral Form

 

Brochure

Institute Brochure

Dizziness and Balance Disorders