Downloadable forms from Champlain Valley Audiology

You may complete the new patient paperwork before your appointment and bring them with you or fax them to (518) 324-5726, or scan them to help@cvaudiology.com. Please plan to arrive at least 15 minutes prior to your appointment to review any other necessary New Patient information.

  • For adult hearing testing: Adult Patient Forms
  • For pediatric hearing testing: Child Patient Forms
  • For tinnitus concerns: Adult Forms and Tinnitus Patient Forms
  • For hearing aid evaluation: Adult or Child Forms and Companion Questionnaire
Adult Patient Forms
Download
Child Patient Forms
Download
Companion Questionaire
Download
Tinnitus Patient Forms
Download
Waiver of Non-Coverage for Tinnitus
Download