Get Hearing Aids Complaint Form - Speech-language Pathology And ...

This guide provides clear and comprehensive instructions on how to fill out the Hearing Aids Complaint Form online. Whether you are filing a complaint about a hearing aid dispenser or seeking clarification on your experience, this guide is designed to support you throughout the process.

Follow the steps to easily complete your complaint form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Print or type your name in the designated field labeled 'Name'. Ensure your input is clear to facilitate communication.
3. Indicate the name of the person registering the complaint in the specified line. Provide a contact number in the home telephone section.
4. Identify the person or entity the complaint is registered against by filling in their name, address, and business telephone number.
5. Explain your complaint in detail in the space provided. Be as thorough as possible to give context to your claim.
6. Answer the questions regarding your examination by a physician and whether it was an ear specialist. Indicate if you signed a waiver to avoid an examination and provide the date of the exam.
7. Include information about any adjustments made to the hearing aid or ear mold, whether the aid was returned to the factory, and whether you received any credit for a trade-in.
8. If your complaint pertains to advertising, attach an original copy of the related advertisement.
9. Authorize the release of any information relevant to your case by signing and dating the form at the designated sections.
10. Finally, review the completed form for accuracy before submitting it. You can save your changes, print, or share the form as needed.

Take the next step and complete your complaint form online today.