Patient Forms

For your convenience, below you will find forms that you may wish to download and complete prior to your scheduled appointment. Alternatively, you can fill out these forms online using our online patient portal.



To our patients,


Given the reputation of our physicians and audiologists, it is not always easy for us to accommodate your scheduling requests. While we always strive to get you an appointment as quickly as possible, sometimes we are simply unable to get you an appointment as quickly as you might like. To better serve you, we will be charging $50 for patients who do not show up for their appointment and $25 for patients who cancel in less than one business day. We feel that if we encourage people to provide adequate notice for canceling an appointment, we can fill those time slots and accommodate more patients.

Respectfully,

Jim Wallach, M.P.A.
Practice Administrator

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