Get Phonak Government Services Order Forms

Filling out the Phonak Government Services Order Forms online can be straightforward when approached step by step. This guide will assist you in properly completing each section of the form to ensure accurate processing.

Follow the steps to fill out the Phonak Government Services Order Forms online.

1. Press the ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter the date and payer information, including purchase order number, account number, address, contact details, email, and phone number.
3. Provide patient information by entering the patient's first name, last name, and the last four digits of their identification.
4. Select whether to use a scan on file or to send new impressions.
5. Input hearing aid information, including the model and serial number for both right and left hearing aids.
6. If applicable, indicate if this order is a duplicate of a previous one and, if so, return the form to Phonak.
7. Choose style options for the earmold, including material and color preferences for right and left sides.
8. Enter the audiogram details, ensuring to include the necessary frequency range.
9. Select tubing options as required, and indicate any preferences for wax prevention.
10. Provide any special instructions necessary to complete the order.
11. Review the entire form for accuracy, ensuring all sections are completed.
12. Once finished, save changes, download, print, or share the form as needed.

Complete your Phonak Government Services Order Forms online today!