Client Forms

Elkhart Audiology Client Forms

In an effort to better serve our clients, we have made some of the more common forms that we use available via our web site. One of our primary goals is to be as convenient if possible, so rest assured that we are happy to provide them in person as well. If you have any questions, don’t hesitate to ask!


EAR Patient Registration
EAR Release of information
HIPPA Consent Information
EAR Patient Financial Policy
EAR Identity Theft Prevention
EAR Patient Solicitation Policy
EAR Adult History Form

Additional Resources:

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Meet your Audiologist

Hi, I'm Sharon!

elkhart audiologist My foundation in faith and family has allowed me to face challenges and grow into an expert in hearing health care. I have immediate family in Elkhart, Indianapolis, Jimtown, Middlebury...
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Find Elkhart Audiology

Contact Us

Elkhart Audiology Rehab
663 CR 17, Ste.1
Elkhart, IN 46516
(574) 262-EARS (3277)

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Hours

Please call ahead for an appointment reserved just for you!

Monday: 1pm to 6pm
Tuesday: 8am-4:30pm
Wednesday: 8am-4:30pm
Thursday: 8am-6pm
Friday: 8am-Noon