Audiology Client History Forms
Intake Forms
Below are the forms necessary for new patients to be seen at WWU's Hearing Clinic. If you have questions about which forms to complete, or how best to complete them please reach out to our front desk at (360) 650-3881.
Audiology Intake Forms - English
Adult Client Intake Form
- Fillable PDF
- Print Word
Pediatric Client Intake Form (17 years and younger)
- Fillable PDF
- Print Word
Clinic Consents and Policies Form
- Fillable PDF
- Print Word
Cochlear Implant Addendum
- Fillable PDF
- Print Word
Dizziness Addendum
- Fillable PDF
- Print Word
Tinnitus Addendum
- Fillable PDF
- Print Word
Formularios de admisión de audiología
Formulario de Informacíon del Paciente
- Imprimir
Clínica de Audiología: Formulario de Historial Médico para
Adultos
- Imprimir
Clínica de Audiología:
Formulario de Historial Médico para Bedés y Niños
- Imprimir
Formulario de consentimientos y políticas de la clínica
- Imprimir Word