Refer A Patient

If you have a patient that would benefit from visiting our team of hearing experts, then please complete this form.

Upon completion, we’ll contact the patient to schedule a convenient date/time for their appointment.

Thanks for all you do.

Have a question or need help? Then please call us at (541) 612-7555.

Erika and her staff are well beyond AMAZING! Everyone there treats you more like a friend rather than a patient . I just received my new hearing aids and they are absolutely awesome. I’m hearing sounds I haven’t heard in a long time. The best thing is when you have an appointment you will never feel rushed or pushed thru. I just can’t say enough good things about these people. I will not go anyplace else. I highly recommend Erica and her staff. If this had a rating of 100 stars I would rate them at 100. It don’t get any better than right here.

Larry Jacobson

Refer A Patient

Your Name
Patient's Name
Patient's Email

Patient's Phone Number
Patient's Insurance Provider
Consent*
By providing a telephone number and submitting this form you are consenting to be contacted by SMS text message. Message & data rates may apply. You can reply STOP to opt-out of further messaging.

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Refer A Patient

Refer A Patient

Patient Resources

Understanding Third-Party Hearing Aid Benefits

Why Are My Hearing Aids Whistling?

Common Causes and Types of Tinnitus