Patient Forms – Harmony Hearing & Audiology

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Patient Forms

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For new adult patients:

Adult Patient History — Adult History

New Patient Information — New Patient Info

HIPAA Privacy Statement — HIPAA Statement

For new pediatric patients:

Child Patient History — Child History

New Patient Information — New Patient Info

HIPAA Privacy Statement — HIPAA Statement

For new dizziness patients:

VNG Instructions	Adult History	New Patient Info
HIPAA Statement	Dizziness History