New Patient Forms

Welcome to Francis Audiology Associates

Directions: Please print and fill out all 5 pages and bring them to your scheduled appointment. If you have any questions or need help completing the forms I will help you when we meet. Please remember to bring any insurance cards you have.

I look forward to meeting with you and Happy Hearing!


Admission Sheet
Health Questionnaire
Hearing Handicap Inventory Questionnaire
HIPPA Acknowledgement