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  • 621 East Center Ave., Mooresville, NC 28115
  • Monday - Friday 9:00 AM - 5:00 PM

Patient Forms

Patient Forms

Download and Print our Patient Forms

Patient forms can be completed and submitted online securely through our Patient Portal or through the link sent to you via e-mail when you scheduled your appointment. They may also be printed below to complete and return to us at the office if you prefer.


Please select one history form to complete based on your age.


HIPAA and financial policies must be reviewed and signed by all patients prior to their first appointment. They will need to be completed again any time there are updates to the policies.

Telehealth patients: You must review and sign a telehealth waiver prior to your first telehealth appointment and/or prior to your hearing aid programming if you will be connecting to the hearing aids via a smartphone remote control app. This waiver will need to be completed again any time there are updates. Please note: You must be in the state of North Carolina at the time of your telehealth appointment.

Important COVID-19 Announcement!