Get Westone Order Form

Filling out the Westone Order Form online can streamline your ordering process, ensuring that all essential information is accurately captured. This guide provides clear and detailed instructions for completing each section of the form, making it user-friendly for all levels of experience.

Follow the steps to complete your Westone Order Form online.

1. Click ‘Get Form’ button to initiate the download of the form and open it in your preferred online editor.
2. Begin by entering the patient's name, age, and date at the top of the form. Ensure this information is accurate to prevent delays.
3. Provide dispenser information in the designated 'Bill To' section. Include all addresses, your Westone account number, and contact details for the person submitting the order.
4. Select the shipping instructions. Choose to ship to the dispenser, the patient, or another address. Specify the desired shipping method; options include FedEx Priority Overnight or Standard Shipping.
5. In the 'Billing Method' section, indicate whether you will pay via Westone account, check, or credit card. If using a credit card, provide the necessary information including card number and expiration date.
6. Detail any special requests or information needed for your earpiece order. This is important for custom specifications.
7. Choose earpiece styles for both the left and right ear. Specify any fitting requirements and preferences regarding materials and colors, as indicated in different sections of the form.
8. Complete the hearing loss section by indicating the severity level and provide an audiogram if applicable. This ensures proper fitting and functionality of the earpiece.
9. Choose any venting options and tubing types as applicable, ensuring to select options that fit your earpiece style.
10. Review all sections carefully, ensuring all fields are completed accurately. Once done, save your changes, download, print, or share the completed form as needed.

Complete your Westone Order Form online today for a streamlined order experience.