Get Oticon Earmold Order Form

Filling out the Oticon Earmold Order Form online is a straightforward process that ensures accurate and efficient ordering of earmolds. This guide will provide you with step-by-step instructions to help you complete the form with confidence and ease.

Follow the steps to successfully complete your order form.

1. Click 'Get Form' button to access the Oticon Earmold Order Form and open it in your preferred online editor.
2. Provide the fitter's information, including the fitter's name, phone number, and email. Don't forget to fill out the purchase order number and company name.
3. Enter today's date and complete your information, including your customer number, name, and phone number.
4. Fill in the patient information section with the patient's address, first name, last name, city, state, and zip code.
5. Select the new instrument model from the options provided, such as miniRITE or miniRITE-T, and enter the patient's age and last four digits of their Social Security number.
6. Specify the color and quantity of earmolds requested, including ear size and power level options for both the right and left ears.
7. Complete the audiometric information section, providing required details for correct earmold fitting.
8. Fill out the venting information, choosing from available vent options for both the right and left sides.
9. Review the selected mold styles and materials. Indicate your preferences regarding retention locks and other specific features.
10. After filling out all sections and confirming accuracy, save your changes. You can then download, print, or share the completed Oticon Earmold Order Form.

Start completing your Oticon Earmold Order Form online today for a smoother ordering experience.