Patient Resources
Patient Forms • Hearing Aids • Testimonials
Patient Forms
Hearing Healthcare Of Illinois looks forward to having you join our host of satisfied patients. Each of our hearing specialists has a schedule tailored for your convenience. To schedule an appointment, please call us at (815) 399-5279. To request an appointment online, please use our interactive Online Appointment Request Form.
Once you have made your initial appointment, you can pre-register online by simply clicking on the links below. Please complete the forms and click on submit. Alternately, you may download the forms, print them, fill them out and bring them with you to your visit. Completing the forms prior to your visit will help to speed up the new patient registration process and get you in to see the doctor faster!
Interactive Forms
Downloadable Form
Please note: It may take a few minutes to load the forms if you are using a dial-up Internet Connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.
If you register, make an appointment or submit any other information online, all your information is transmitted securely and is held in strictest confidence, adhering to HIPAA guidelines and protecting your privacy.
Patient Resources
Patient Forms • Hearing Aids • Testimonials
Patient Forms
Hearing Healthcare Of Illinois looks forward to having you join our host of satisfied patients. Each of our hearing specialists has a schedule tailored for your convenience. To schedule an appointment, please call us at (815) 399-5279. To request an appointment online, please use our interactive Online Appointment Request Form.
Once you have made your initial appointment, you can pre-register online by simply clicking on the links below. Please complete the forms and click on submit. Alternately, you may download the forms, print them, fill them out and bring them with you to your visit. Completing the forms prior to your visit will help to speed up the new patient registration process and get you in to see the doctor faster!
Interactive Forms
Downloadable Form
Please note: It may take a few minutes to load the forms if you are using a dial-up Internet Connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.
If you register, make an appointment or submit any other information online, all your information is transmitted securely and is held in strictest confidence, adhering to HIPAA guidelines and protecting your privacy.