Patient Form

This form complies with the Federal Health Insurance Portability and Accountability Act (HIPAA). This is a secure form; the information that you enter here will be seen only by the staff of our practice.

Directions: fill out all applicable fields and submit the form. We will contact you if there are any concerns or errors with your submission.

Paul Richards
Paul Richards
2021-08-08
Great place they do everything to help you.
Cari Carson
Cari Carson
2021-07-18
I had a great experience at Focus hearing. The people are very friendly and the Doctor I worked with was very nice and answered all my many questions I had about hearing aids. I was very impressed.
James Wonderly
James Wonderly
2021-07-15
Stopped in without an appointment. Had a minor problem with receiver retention broke. They replaced it and gave me 3 extra to take home. Very impressed.
Larry P
Larry P
2021-07-12
Great service! Appreciate the walk-in accommodations.
Jack Lynch
Jack Lynch
2021-06-24
Good experience!