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Hearing Aid Adjustment & Repair Form

You can now post your Hearing aid/cochlear/baha devices to our clinics for adjustments – Simply complete this form and mail your devices into us. Please ensure you provide a detailed description of any issues or adjustments that need to be done.

 

  • Your Details

  • Return Mailing Address

  • Mobile Phone
  • Video Chat Function Used: e.g. Facetime, Skype, messenger or can you download a video chat application
  • Email Address
  • Usual clinic location
  • Hearing Aid's
  • Detailed Issue Description
  • Please list any accompanying supplies you require