Laura O. Robertson, Au.D

Doctor of Audiology

(603) 528-7700 • Toll Free (800) 682-2338
Fax (603) 528-9623

211 South Main Street
Laconia, New Hampshire 03246
info@audiologyspecialists.com

 

New Patient Forms

 

We Want Time to Hear Your Concerns

In order to allow you the fullest amount of time to converse with the audiologist about your hearing concerns, it is recommended that all new patients complete the forms provided in this section prior to their initial visit. You may also call our office if you would like these forms mailed to you.

formsTending to these forms in advance will also allow you more time to gather the information requested and seek help from a family member if necessary.

All forms can be returned by regular mail at the address provided at the top of this page, by emailing them to info@audiologyspecialists.com, or dropped off anytime at our office.

Forms are in pdf PDF format which requires Adobe Acrobat Reader to view.
Click here to download free software.

 

The Value in Choosing Audiology Specialists
Patient Information Sheet
Patient Health Questions
Medications
Marketing Release
Hearing Challenges
Fall Risk Questions
Adult History Questionnaire

 

 

"I have been impressed with the care and service I receive from Dr. Robertson at Audiology Specialists, LLC. I was recently told by my friends that it was very nice to no longer have to repeat themselves to me."

-Bruno Siniscalchi, Moultonboro, NH

AUDIOLOGY SPECIALISTS, LLC

211 South Main Street • Laconia, New Hampshire 03246

(603) 528-7700 • (800) 682-2338info@audiologyspecialists.com

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