Get Westone Order Form

The Westone Order Form is a crucial document used to facilitate the ordering process for custom earpieces. This guide provides a clear and supportive walkthrough of each step necessary to complete the form online effectively.

Follow the steps to complete your Westone Order Form accurately.

1. Click 'Get Form' button to access the Westone Order Form and open it in your preferred digital editor.
2. Begin by filling out the patient's name and age, followed by the date of submission in the designated fields.
3. Provide the dispenser information, including the dispenser's name, address, phone number, and any applicable shipping codes and P.O. numbers.
4. Select the shipping instructions indicating the preferred shipping method and address, whether it be the dispenser, patient, or another address.
5. Choose the billing method from options such as Westone account or credit card, confirming if you have enclosed a check or money order.
6. Fill in the earpiece style, including details for the left and right earpieces and relevant manufacturer and model information.
7. Complete the special requests section if applicable, especially if this is a remake involving prior invoices or earpiece numbers.
8. Indicate the hearing loss status and complete the audiogram as required.
9. Select preferred venting and tubing options based on your needs, ensuring you provide any necessary measurements.
10. Fill in the miscellaneous information regarding earpiece finish, colors, and any additional notes.
11. Review all completed sections of the form thoroughly to ensure accuracy before saving your changes, then proceed to download, print, or share the completed form as needed.

Start your order process by completing the Westone Order Form online today.