Follow the steps to fill out your form with ease.

1. Press the ‘Get Form’ button to acquire the form and open it in your chosen editor.
2. Begin with the fitter's information section. Fill in the current date, fitter's name, phone number, email address, company name, and shipping address.
3. Enter your information, including your customer number and fitting date. Ensure to provide a reachable phone number.
4. Complete the patient information section with the first and last name, age, city, state, and zip code of the individual receiving the earmold.
5. In the bill to information area, fill in the bill to number and indicate whether you are fitting an existing instrument by referencing the back panel of the form.
6. Specify the type of speaker you are fitting, choosing from the options provided (e.g., standard, medium, or power) and fill in any relevant details regarding the patient’s existing instrument.
7. Select the appropriate RITE mold style from the provided options, keeping in mind the different custom earmold choices available.
8. Choose the material for the earmold and any special instructions for customization as necessary.
9. Fill out the venting information according to the specifications needed for the earmold.
10. Finally, ensure all fields are correctly completed, and then save your changes. You can download, print, or share the completed form as required.

Complete your documents online for a seamless and efficient process.