Hearing Aids Advice Questionnaires & Consent Form

Please complete the following prior to your appointment


I understand that the personalised hearing aids advice from Melody Hear For You is based on the information I provided in order to guide me in choosing the suitable hearing aids, but I should always discuss with my hearing devices provider regarding what hearing devices are most suitable for my hearing loss before purchasing.


I understand that all records are confidential and governed by the Privacy Act. Provision of my personal information to any other person or agency will require my written consent.


Please complete payment at least 24hours before the appointment by credit card (sub-charge applies) or direct bank transfer as specified on your invoice. If due to unforeseen circumstances we need to cancel your appointment, a full refund will be provided.